title: Comprehensive Comparison of the Performance of Autogenous Brachial-Basilic Transposition Arteriovenous Fistula and Prosthetic Forearm Loop Arteriovenous Graft in a Multiethnic Asian Hemodialysis Population.
abstract: Aim.For patients who have exhausted cephalic vein arteriovenous fistula (AVF) options, controversy exists on whether brachial-basilic AVF with transposition (BBTAVF) or a forearm arteriovenous graft (AVG) should be the next vascular access of choice. This study compared the outcomes of these two modalities.Methods.A retrospective study of 122 Asian multiethnic patients who underwent either a BBTAVF (81) or an AVG (41). Maturation time and intervention rates were analyzed. Functional primary, secondary, and overall patency rates were evaluated.Results.The maturation time for BBTAVFs was significantly longer than AVGs. There was also a longer deliberation time before surgeons abandon a failing BBTAVF compared to an AVG. Both functional primary and secondary patency rates were significantly higher in the BBTAVF group at 1-year follow-up: 73.2% versus 34.1% (p< 0.001) and 71.8% versus 54.3% (p= 0.022), respectively. AVGs also required more interventions to maintain patency. When maturation rates were considered, the overall patency of AVGs was initially superior in the first 25 weeks after creation and then became inferior afterwards.Conclusion.BBTAVFs had superior primary and functional patency and required less salvage interventions. The forearm AVG might have a role in patients who require early vascular access due to complications from central venous catheters or with limited life expectancy.
authors.affiliation: University Surgical Cluster, National University Health System, 1E Kent Ridge Road, Singapore 119228.
authors.forename: Koy Min
authors.initials: KM
authors.lastname: Chue
authors.affiliation: University Surgical Cluster, National University Health System, 1E Kent Ridge Road, Singapore 119228.
authors.forename: Kyi Zin
authors.initials: KZ
authors.lastname: Thant
authors.affiliation: Department of Cardiac, Thoracic and Vascular Surgery, National University Health System, 1E Kent Ridge Road, Singapore 119228.
authors.forename: Hai Dong
authors.initials: HD
authors.lastname: Luo
authors.affiliation: Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore 117597.
authors.forename: Yu Hang Rodney
authors.initials: YH
authors.lastname: Soh
authors.affiliation: University Surgical Cluster, National University Health System, 1E Kent Ridge Road, Singapore 119228; Department of Cardiac, Thoracic and Vascular Surgery, National University Health System, 1E Kent Ridge Road, Singapore 119228.
authors.forename: Pei
authors.identifier: 0000-0003-4560-2374
authors.initials: P
authors.lastname: Ho
mesh_terms: D001164:Arteriovenous Fistula / Q000601:surgery*; D001186:Artificial Limbs; D044466:Asian People; D018592:Cross-Over Studies; D003710:Demography; D005006:Ethnicity; D005260:Female; D005542:Forearm / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D016879:Salvage Therapy; D013997:Time Factors; D017211:Treatment Failure; D014654:Vascular Patency