Long-term Outcomes of Brachiobasilic Transposition Fistula for Haemodialysis

Objectives. The transposed basilic vein to brachial artery arteriovenous fistula provides secondary vascular access for haemodialysis. The long-term results of such fistula are assessed in this retrospective series. Material and methods. Over a 5-year period 75 brachiobasilic transposition fistulae...

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Bibliographic Details
Published in:European journal of vascular and endovascular surgery 2003-12, Vol.26 (6), p.670-672
Main Authors: Taghizadeh, A, Dasgupta, P, Khan, M.S, Taylor, J, Koffman, G
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Arteriovenous shunt
Arteriovenous Shunt, Surgical - adverse effects
Arteriovenous Shunt, Surgical - methods
Axillary Vein - physiopathology
Axillary Vein - surgery
Brachial artery
Brachial Artery - physiopathology
Brachial Artery - surgery
Catheters, Indwelling - adverse effects
Child
Female
Follow-Up Studies
Humans
Kidney Failure, Chronic - therapy
Male
Middle Aged
Renal dialysis
Renal Dialysis - methods
Retrospective Studies
Time Factors
Treatment Outcome
Vascular Patency - physiology
Veins
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Summary:Objectives. The transposed basilic vein to brachial artery arteriovenous fistula provides secondary vascular access for haemodialysis. The long-term results of such fistula are assessed in this retrospective series. Material and methods. Over a 5-year period 75 brachiobasilic transposition fistulae were performed in 74 patients. There was a median follow up of 14 months. Results. Primary patency was achieved in 69 (92%) of the fistulae, and secondary patency in 74 (99%) of the fistulae. Successful interventions included angioplasties in four, and saphenous vein interposition in one, whilst three patients had failed thrombectomies. Dialysis was performed using 69 (92%) of the fistulae while 6 (8%) were never used. Of the 75 fistulae 47 (63%) were patent at follow up. Cumulative secondary patency was 66% at 1 year, 52% at 2 years, and 43% at 3 years. Complications developed in 41 (55%), and included thrombosis, infection, stenosis, arm oedema, bleeding, steal syndrome and microaneurysm formation. Conclusions. Brachiobasilic transposition fistulae have good long-term patency rates. The complication rate, although high, is lower than that reported for PTFE grafts. Brachiobasilic fistulae should be used in preference to PTFE grafts for secondary access.
ISSN:1078-5884
1532-2165
DOI:10.1016/j.ejvs.2003.09.002