title: Comparison between autogenous brachial-basilic upper arm transposition fistulas and prosthetic brachial-axillary vascular accesses for hemodialysis.
abstract: OBJECTIVE
  The aim of this paper was to compare the outcomes of patients undergoing autogenous brachial-basilic upper arm transposition fistulas (BBAVF) with prosthetic brachial-axillary vascular accesses (BAPTFE) at immediate and medium follow-up.
  
  
  METHODS
  Retrospective analysis of the aforementioned accesses performed in a single-center from 2003 to 2007. Transposition was used in all BBAVF performed. Conic prostheses were used in the BAPTFE. Primary and secondary patency, patient survival, types of complications and its rates were assessed during follow-up.
  
  
  RESULTS
  Thirty-six BBAVF and 40 BAPTFE were performed. Both groups were well matched for age, gender and comorbidity. BBAVF primary patency was 93.5%, 50.4%, 45.8% and 45.8% compared to 80.6%, 64.3%, 46.2% and 31.6% of the BAPTFE group at 1, 12, 24 and 36 months of follow-up (P=0.719). BBAVF secondary patency was 93.5%, 50.4%, 45.8% and 45.8% compared to 80.6%, 67.7%, 54.2% and 35.1% of the BAPTFE at the same periods (P=0.902). Patient survival was 97.2%, 97.2%, 93.2% and 86.5 for BBAVF in contrast to 97.2%, 94.4%, 84.1% and 79.9% for BAPTFE in the same months (P=0.386). 13.8% of the BBVAF had accessibility problems while only 5% of the BAPTFE presented them (P=0.174). Infection was more frequent in BAPTFE (0% vs 10%), being the only complication near the statistical signification (P=0.071).
  
  
  CONCLUSIONS
  BBAVF offer patency and accessibility rates similar to BAPTFE, but lower infectious complications. Thus, we consider them as the preferred hemodialysis access when fistulas using the cephalic vein have failed or are not possible.
authors: Angiology and Vascular Surgery Department, Hospital Universitario Doctor Peset, Valencia, Spain. sala_and@gva.es
authors: V
authors: V
authors: Sala Almonacil
authors: A
authors: A
authors: Plaza Martínez
authors: J
authors: J
authors: Zaragozá García
authors: C
authors: C
authors: Martínez Parreño
authors: B
authors: B
authors: Al-Raies Bolaños
authors: F
authors: F
authors: Gómez Palonés
authors: E
authors: E
authors: Ortíz Monzón
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000401:mortality; D001367:Axillary Vein / Q000601:surgery*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D001916:Brachial Artery / Q000601:surgery*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D016459:Prosthesis-Related Infections / Q000209:etiology; D006435:Renal Dialysis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013030:Spain; D013530:Surgical Wound Infection / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome; D034941:Upper Extremity / Q000098:blood supply*; D014654:Vascular Patency; D055815:Young Adult