title: Unusual vascular access for hemodialysis: transposed venae comitante of the brachial artery.
abstract: The National Kidney Foundation Dialysis Outcomes Quality Initiative guidelines favor autogenous vein for arteriovenous fistulas. This report describes our technique and results of arteriovenous fistulas between brachial artery and its transposed venae comitantes. The procedure was done in two stages, first anastomosis between brachial artery at the elbow and one of its venae comitantes and, 1 month later, transposition of the vein to a subcutaneous tunnel. The study included 21 patients (15 males, six females), nine of whom were diabetic, with a mean age of 53 years. The cumulative primary patency rate was (75.89%) at 1 year and (55.34%) at 2 years. Complications developed in 11/21 fistulas, including thrombosis, infection, aneurysm formation, and nonmaturation of the vein. Brachial artery to its transposed venae comitante fistula is an alternative access which can be used as a tertiary autogenous access.
authors.affiliation: Vascular Surgery Unit, Mansoura University Hospital, Mansoura, Egypt. wakeel_hossam@hotmail.com
authors.forename: Hossam A
authors.initials: HA
authors.lastname: Elwakeel
authors.forename: Ehab M
authors.initials: EM
authors.lastname: Saad
authors.forename: Yasser M
authors.initials: YM
authors.lastname: Elkiran
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Awad
mesh_terms: D000328:Adult; D000368:Aged; D000783:Aneurysm / Q000209:etiology; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects / Q000379:methods*; D001916:Brachial Artery / Q000601:surgery*; D002408:Catheters, Indwelling; D004550:Elbow / Q000098:blood supply; D005260:Female; D005500:Follow-Up Studies; D005542:Forearm / Q000098:blood supply*; D006406:Hematoma / Q000209:etiology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D006435:Renal Dialysis / Q000379:methods*; D013530:Surgical Wound Infection / Q000209:etiology; D013927:Thrombosis / Q000209:etiology; D016896:Treatment Outcome; D014654:Vascular Patency / Q000502:physiology; D014680:Veins / Q000601:surgery