The authors report 42 subcutaneous transpositions of arterialized deep upper arm veins for hemodialysis angioaccess: 37 basilic (BaF) and 5 brachial (BrF) fistulas, done in 38 patients, 18 of them diabetics, with local anesthesia. Indications for BaF and BrF creation were surgically exhausted forearm veins and/or severe arteriosclerotic changes of distal arteries. No neurologic or circulatory complications were seen. Cumulative patency rates for all fistulas was 100% at the first month and 82% one year after surgery. BaF and BrF are optimal autogenous alternatives to synthetic grafts.
Get full access to this article
View all access options for this article.
References
1.
Dagher FJ: The upper arm AV hemoaccess: Long term follow-up. J Cardiovasc Surg Torino27:447-449, 1986.
2.
Barrett SM, Waters WC III, Lowance DC, et al: The basilic vein fistula for vascular access. Trans Am Soc Artif Intern Organs25:344-346, 1979.
Hatjibaglou A., Grekas D., Saratzis N., et al: Transposed basilic vein-brachial arteriovenous fistula: An alternative vascular access for hemodialysis. Artif Organs16:623-625, 1992.
5.
Rivers SP, Scher LA, Sheehan E., et al: Basilic vein transposition: An underused autologous alternative to prosthetic dialysis angioaccess. J Vasc Surg18:391-396, 1993.
6.
Matthews DE, Farewell V.: Using and Understanding Medical Statistics. Basel: Karger, 1985, pp 67-78.
7.
Jenkins AM, Buist Tas, Glover SD: Medium-term follow-up of forty autogenous vein and forty polytetrafluoroethylene (Gore-Tex) grafts for vascular access. Surgery88:667-672, 1980.
8.
Kherlakian G. , Roedersheimer RL, Arbaugh JJ, et al: Comparison of autogenous fistula versus expanded polytetrafluoroethylene graft fistula for angioaccess in hemodialysis . Am J Surg152:238-243, 1986.
9.
Pontari MA, McMillen MA: The straight radial antecubital PTFE angioaccess graft in an era of high flux dialysis. Am J Surg161:4.450-4.453, 1991.
10.
Churchill DN , Taylor DW, Cook RJ, et al: Canadian hemodialysis morbidity study . Am J Kidney Dis19:214-234, 1992.
11.
Keoghane SR , Leow CK: Routine use of arteriovenous fistula construction to dilate the venous outflow prior to insertion of an expanded polytetrafluoroethylene (PTFE) loop graft for hemodialysis. Nephrol Dial Transpl 8:154-156, 1993.
12.
Hibberd AD: Brachiobasilic fistula with autogenous basilic vein: Surgical technique and pilot study. Aust NZ J Surg61:631-635, 1991.
13.
Tellis VA, Kohlberg WI, Bhat DJ, et al: Expanded polytetrafluorethylene graft fistula for chronic hemodialysis . Ann Surg189:101-105, 1979.
14.
Coburn MC, Carney WI Jr: Comparison of basilic vein and polytetrafluorethylene for brachial arteriovenous fistula. J Vasc Surg20:896-902, 1994.