Arteriovenous fistula formation using transposed basilic vein: extensive single centre experience.
OBJECTIVE
The expanding haemodialysis population has lead to increased requirement for more complex vascular access. The aim of this study is to present the results of an extensive series of brachiobasilic arteriovenous fistulae.


METHODS
BBAVF were performed using single-stage vein transposition. A retrospective review of case notes was performed.


RESULTS
One hundred and sixty eight BBAVF were created in 144 patients. This was the first access procedure in only 30 cases and the fourth or fifth in 30. At 24h, 165 fistulas (98%) were patent. One hundred and eleven fistulas (66%) were used for haemodialysis and 57 (34%) were never used, of which 39 (23%) were due to fistula failure. The cumulative secondary patency at 1, 2 and 3 years was 66%, 50% and 41% respectively. There were 201 complications in 119 patients (71%), including thrombosis (29%), arm oedema (17%), infection (13%) and arterial steal syndrome (11%). Ten angioplasties and 48 operative procedures were performed for complications. Pre-operative ipsilateral subclavian catheter had been placed in 62 cases (37%) and was associated with poor patency.


CONCLUSIONS
BBAVF represents an important option for vascular access with acceptable patency rates, although complication rates remain significant.
Harper
S J F
SJF
Transplantation Division, Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK. Electronic address: sjfharper@hotmail.com.
Goncalves
I
I
Transplantation Division, Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK.
Doughman
T
T
Transplantation Division, Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK.
Nicholson
M L
ML
Transplantation Division, Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001132:Arm / Q000098:blood supply*; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects / Q000379:methods*; D001916:Brachial Artery / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency; D014680:Veins / Q000503:physiopathology / Q000601:surgery