title: Promising Results of the Forearm Basilic Fistula Reveal a Worthwhile Option between Radial Cephalic and Brachial Fistula.
abstract: BACKGROUND
  Use of the forearm basilic vein for the creation of an arteriovenous fistula has been codified as second-choice vascular access for hemodialysis in the last clinical guidelines of the Society for Vascular Surgery in 2008. Poor literature data on this technical option and on its evaluation and outcomes led us to initiate a retrospective single-center study.
  
  
  METHODS
  We analyzed the outcomes of every arteriovenous fistula using the forearm basilic vein created in our department. It is a retrospective study in which we collected data prospectively by contacting dialysis centers, nephrologists, and patients. Primary end point was primary patency rate at 1 year. Secondary end points were secondary patency rate at 1 year, time of maturation, and Doppler flow measurement before the first puncture.
  
  
  RESULTS
  From February 2004 to June 2014, 49 forearm basilic arteriovenous fistulas were created: 33 ulnar-basilic and 16 radial basilic arteriovenous fistulas. Initial technical success rate was 98%. Functional success rate was 60%. Primary and secondary patency rates at 1 year were respectively 21% and 48%. Median time of maturation was 81 days, and mean Doppler flow measurement was 678 mL/min. Ulnar-basilic fistulas had a statistically significant shorter time of maturation than radial basilic fistulas (P ≤ 0.05).
  
  
  CONCLUSIONS
  Despite poor primary patency rate and a long time of maturation, forearm basilic arteriovenous fistula has satisfactory secondary patency rate and keeps all the advantages of a distal-located vascular access concerning complications. It is worth its second-choice place in the current algorithm of creation of vascular access for hemodialysis.
authors.affiliation: Department of Vascular Surgery and Kidney Transplantation, Nouvel Hôpital Civil, Strasbourg, France.
authors.forename: Adeline
authors.initials: A
authors.lastname: Schwein
authors.affiliation: Department of Vascular Surgery and Kidney Transplantation, Nouvel Hôpital Civil, Strasbourg, France. Electronic address: yannick.georg@chru-strasbourg.fr.
authors.forename: Yannick
authors.initials: Y
authors.lastname: Georg
authors.affiliation: Department of Vascular Surgery and Kidney Transplantation, Nouvel Hôpital Civil, Strasbourg, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Lejay
authors.affiliation: Department of Vascular Surgery and Kidney Transplantation, Nouvel Hôpital Civil, Strasbourg, France.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Roussin
authors.affiliation: Department of Vascular Medecine, CHU, Strasbourg, France.
authors.forename: Sebastien
authors.initials: S
authors.lastname: Gaertner
authors.affiliation: Department of Nephrology, Nouvel Hôpital Civil, Strasbourg, France.
authors.forename: Dorothée
authors.initials: D
authors.lastname: Bazin-Kara
authors.affiliation: Department of Vascular Surgery and Kidney Transplantation, Nouvel Hôpital Civil, Strasbourg, France.
authors.forename: Fabien
authors.initials: F
authors.lastname: Thaveau
authors.affiliation: Department of Vascular Surgery and Kidney Transplantation, Nouvel Hôpital Civil, Strasbourg, France.
authors.forename: Nabil
authors.initials: N
authors.lastname: Chakfe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects / Q000379:methods*; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005542:Forearm / Q000098:blood supply*; D005602:France; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D017534:Radial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D012039:Regional Blood Flow; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000628:therapy*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D014654:Vascular Patency; D014680:Veins / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D055815:Young Adult