title: Our experience in using the brachial venae comitantes as a native vascular access for hemodialysis.
abstract: A native arteriovenous fistula is the preferred vascular access for patients on long-term hemodialysis. In the absence of suitable superficial veins, the deep venous system can be used. We intend to present our experience in using the brachial venae comitantes (VC) to create a native arteriovenous fistula. From January 2012 to December 2014, we utilized the brachial vena comitantes to create 12 arteriovenous fistulae. Data from these 12 subjects were analyzed retrospectively to produce this case series. The average age of our subjects was 55.6 years. Forty-two percent of the subjects were women. Fifty percent of the subjects had diabetes mellitus and 58% had hypertension. We achieved a functional patency rate of 58% at 1 month's follow up after maturation. The brachio-brachial vena comitans fistula is a safe and plausible option in patients with no other suitable veins for a native fistula, more so in the hands of experienced surgeons. The longer time to cannulation has to be taken into consideration when creating a VC fistula. In suitable patients with end-stage renal disease, it can delay the use of an arteriovenous graft or a tunneled central venous catheter.
authors.affiliation: Division of Vascular Surgery, Sarawak General Hospital, Kuching, Sarawak, Malaysia.
authors.forename: Hon Leong
authors.initials: HL
authors.lastname: Sha
authors.affiliation: Division of Vascular Surgery, Sarawak General Hospital, Kuching, Sarawak, Malaysia.
authors.forename: Tien Loong
authors.initials: TL
authors.lastname: Luk
authors.affiliation: Division of Vascular Surgery, Sarawak General Hospital, Kuching, Sarawak, Malaysia.
authors.forename: Sze Chee
authors.initials: SC
authors.lastname: Tee
authors.affiliation: Division of Vascular Surgery, Sarawak General Hospital, Kuching, Sarawak, Malaysia.
authors.forename: Richard
authors.initials: R
authors.lastname: Hardin
authors.affiliation: Division of Vascular Surgery, Sarawak General Hospital, Kuching, Sarawak, Malaysia.
authors.forename: Chen Ken
authors.initials: CK
authors.lastname: Seak
mesh_terms: D000328:Adult; D000368:Aged; D001164:Arteriovenous Fistula / Q000503:physiopathology*; D001916:Brachial Artery / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000379:methods*; D012189:Retrospective Studies; D014654:Vascular Patency / Q000502:physiology*; D014680:Veins / Q000503:physiopathology / Q000601:surgery*
keywords: Brachial venae comitantes; ESRD; arteriovenous fistula