title: Unrecognized high brachial artery bifurcation is associated with higher rate of dialysis access failure.
abstract: A thorough consideration of all factors contributing to successful dialysis access creation is necessary to achieve optimal outcomes. A high bifurcation of the brachial artery (brachioradial variant) occurs in greater than 20% of patients. Dialysis access was created in 22 limbs with this variant--15 fistula, and 7 prosthetic grafts. Nonmaturation occurred in 33% of fistula. Early thromboses occurred in 29% of prosthetic bridge grafts. In this experience, the brachioradial variant is associated with a relatively higher rate of fistula nonmaturation and prosthetic graft thromboses. These findings reinforce the critical role of preoperative imaging studies in dialysis access creation. A sound algorithm for the surgical management of the brachioradial variation facilitates decision making and will improve dialysis access outcomes.
authors: Penn Presbyterian Medical Center, Vascular Surgery, Philadelphia, Pennsylvania 19104, USA. lee.kirksey@uphs.upenn.edu
authors: Lee
authors: L
authors: Kirksey
mesh_terms: D001166:Arteriovenous Shunt, Surgical; D001807:Blood Vessel Prosthesis; D001916:Brachial Artery / Q000002:abnormalities*; D006801:Humans; D006435:Renal Dialysis; D017211:Treatment Failure