title: Outcomes of single-stage compared to two-stage basilic vein transposition fistulae.
abstract: Basilic vein transposition (BVT) fistulae are increasing in prevalence in the United States. We examined outcomes of BVT fistulae created in a single stage compared to those created in two stages. Prospective QA databases identified a consecutive cohort of 144 patients with BVT fistulae. Of these, 42% were created in one stage and 58% in two stages. Fistula maturation rates, mean time to fistula use and intensity of percutaneous interventions were compared; patency rates were compared from time of first intervention. Maturation rates (including assisted maturation) were 90% among 1-stage and 75% among 2-stage BVT (p = 0.02). Mean time to initiation of fistula use was 142 days (1-stage) and 146 days (2-stage) (p = 0.92). Intensity of percutaneous interventions was 1.84/patient-year of dialysis (PYD) (1-stage) and 2.15/PYD (2-stage) (p = 0.57). Secondary patency at 1, 2, 3, and 4 years for 1-stage BVT was 86%, 75%, 69%, and 57%; secondary patency at 1, 2, 3, and 4 years for 2-stage BVT was 76%, 71%, 49%, and 25%, respectively (p = 0.12). BVT creation in two stages confers only a modest reduction in maturation rates and secondary patency and therefore should be considered over a synthetic graft in patients with basilic veins deemed inadequate for 1-stage BVT.
authors: Radiology, University of Pennsylvania, Philadelphia, Pennsylvania.
authors: Amol
authors: A
authors: Agarwal
authors: Mark
authors: M
authors: Mantell
authors: Raphael
authors: R
authors: Cohen
authors: Yan
authors: Y
authors: Yan
authors: Scott
authors: S
authors: Trerotola
authors: Timothy W
authors: TW
authors: Clark
mesh_terms: D001166:Arteriovenous Shunt, Surgical / Q000379:methods*; D001916:Brachial Artery / Q000503:physiopathology / Q000601:surgery*; D016121:Brachiocephalic Veins / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D006435:Renal Dialysis / Q000379:methods*; D016896:Treatment Outcome; D034941:Upper Extremity / Q000098:blood supply*; D014654:Vascular Patency