Primary patency time of basilic vein transposition versus prosthetic brachioaxillary access grafts in hemodialysis patients.
OBJECTIVE
The aim of this study was to compare the primary patency time of basilic vein transposition and prosthetic brachioaxillary access grafts in hemodialysis patients.


METHODS
In this randomized clinical trial, 60 hemodialysis patients who met the inclusion/exclusion criteria were recruited and randomly assigned to two intervention groups; Basilic vein transpositions (BVT) or Arteriovenous access grafts (AVG). Clinical follow-up for patency of the created accesses in at least one year, was performed at two weeks, one, two, three months and then every three months after surgery. Finally, patency rates and access-related complications were compared in the two groups studied.


RESULTS
Thirty BVTs and thirty AVG were performed in each group studied. The groups were well matched for age, sex and comorbidity. After at least one year of follow-up, the access failure rate in the BVT and AVG groups was 23.3% and 30%, respectively. In addition, the mean primary patency time in the BVT and AVG groups was 244.13 ± 103.65 and 264.97 ± 149.28, respectively and there was no statistically significant difference between the two groups studied (P=.533). The common cause of access failure were thrombosis and infection but there were no statistically significant differences between the two groups (P>.05).


CONCLUSIONS
Our results show that AVG offer similar patency and complication rates to BVT. Thus, authors consider them as the preferred hemodialysis access when there are no suitable forearm veins to create arteriovenous fistulas.
Department of Vascular Surgery, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran.
Mahdi
M
Davoudi
Pouya
P
Tayebi
Azadeh
A
Beheshtian
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects / Q000295:instrumentation*; D001367:Axillary Vein / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D001916:Brachial Artery / Q000601:surgery*; D016009:Chi-Square Distribution; D005260:Female; D005542:Forearm / Q000098:blood supply*; D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D007492:Iran; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency