title: Primary success of bifurcated vein patch arteriovenous fistula and Brescia-Cimino methods.
abstract: BACKGROUND
  For continuous hemodialysis, an appropriate vascular access, mostly through an arteriovenous fistula (AVF), is crucial. The Brescia-Cimino (BC) method is a common surgical method for AVF creation. However, this method is sometimes not possible, due to a small venous diameter or its wide distance from the artery. We evaluated the success rate of bifurcated vein patch (BVP) technique as an alternative method to BC for AVF placement in hemodialysis patients.
  
  
  METHODS
  Candidates for AVF vascular access for hemodialysis were assigned into 2 groups of 50 patients, and AVF was placed using the BC method in one group and the BVP method in the other group. Immediate AVF thrill after the operation, first-day postoperation thrill, weighting period, and nursing staff satisfaction for hemodialysis were compared between the BC and BVP methods.
  
  
  RESULTS
  Although the weighting period in the BVP group was longer than that in the BC group, other parameters were similar between the two groups. The AVF thrill intensity after the operation was good to excellent in 87% of the cases with the BC method and good in 95% of those with BVP. Satisfaction of dialysis nursing staff during hemodialysis was reported as 87% good and 4% average in the BC group and 75% good and 20% average in the BVP group.
  
  
  CONCLUSIONS
  Bifurcated vein patch can be an appropriate alternative technique for cases in which the commonly used BC method is not possible for AVF placement.
authors.affiliation: Department of Surgery, Firoozgar Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Jalal
authors.initials: J
authors.lastname: Vahedian
authors.forename: Amir Mohsen
authors.initials: AM
authors.lastname: Jalayifar
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Keramati
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Nabavizadeh
authors.forename: Mohammad
authors.initials: M
authors.lastname: Vahedian
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001166:Arteriovenous Shunt, Surgical / Q000379:methods*; D016121:Brachiocephalic Veins / Q000601:surgery; D002408:Catheters, Indwelling; D005260:Female; D005542:Forearm / Q000098:blood supply; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D017534:Radial Artery / Q000601:surgery; D006435:Renal Dialysis / Q000379:methods*; D013524:Surgical Flaps; D016896:Treatment Outcome; D055815:Young Adult