Transposition of brachiobasilic arteriovenous fistulas: One‐stage or two‐stage technique and factors affecting the early maturation

• Published in: Therapeutic apheresis and dialysis 2021-10, Vol.25 (5), p.636-641
• Main Authors: Ozhan, Abdulkerim, Memetoglu, Mehmet Erdem, Kehlibar, Tamer, Bastopcu, Murat, Yilmaz, Mehmet, Karakaya, Canan, Guler, Erhan, Ketenci, Bulend
• Format: Article
• Language: English
• Subjects: arteriovenous fistula; Arteriovenous Shunt, Surgical - methods; Brachial Artery - surgery; Brachiocephalic Veins - surgery; brachio‐basilic; Female; Follow-Up Studies; hemodialysis; Humans; Male; maturation rate; Middle Aged; Renal Dialysis - methods; Retrospective Studies; surgical technique; Upper Extremity - blood supply; Vascular Patency
• ISSN: 1744-9979; 1744-9987
• DOI: 10.1111/1744-9987.13610

The brachiobasilic transposition (BBT) arteriovenous fistula (AVF) is a valuable option especially for dialysis patients with previously failed vascular access. We aim to report factors affecting the maturation of BBT‐AVF created with either one‐stage or two‐stage technique. BBT‐AVF procedures between January 2015 and May 2019 by a dedicated vascular access team were investigated retrospectively. A total of 122 patients (63 males, 59 females), with 6 to 12 weeks of follow‐up after the BBT‐AVF procedure were included in the study. Patients of one‐stage and two‐stage techniques were compared for maturation rates. Patients with successful and failed maturation were compared for baseline characteristics and anatomic factors. Of 122 BBT‐AVF procedures, 54 were created with the one‐stage and 68 were created with the two‐stage technique. The mean age of the patients was 58.2 ± 13.8, the mean brachial artery and basilic vein diameters were 3.91 ± 1.02 mm, and 3.39 ± 1.16 mm. Of 122 included patients, 88 (72.1%) had mature AVFs at follow‐up. The AVF maturation rates were similar between the one‐ and two‐stage groups (70.4% vs 73.5%; P = .699). Lower age (62.8 ± 12.5 vs 56.5 ± 13.9; P = .023) and greater brachial artery diameter (3.09 ± 0.84 mm vs 4.23 ± 1.76 mm; P