J Korean Soc Vasc Surg.  2000 Apr;16(1):110-114.

Brachio-basilic Arteriovenous Fistula Using Transposed Basilic Vein: An Alternative Vascular Access for Hemodialysis

Affiliations
  • 1Department of Surgery College of Medicine, The Catholic University of Korea, Seoul, Korea. johnpark@cmc.cuk.ac.kr

Abstract

PURPOSE: Effective hemodialysis for a patient with end-stage renal disease (ERDS) is dependent upon a durable, low-morbidity vascular access. Although It is generally agreed that the distal radiocephalic fistula originally discribed by Brescia and Cimino is the most effective primary access constrruction, no consensus exists regarding primary and secondary alternatives for patients with inadequate of failed rediocephalic prodedures. Many options are available, but the relative value of these alternative operations is unclear. Therefore the place of the basilic vein in secondary acccess construction needs to be assessed. We evaluated if the basilic vein can be used to construct a durable, low-morbidity access.
METHODS
A native brachio-basilic arterio-venous fistula with superficial transposition has been performed, for lack of usuable vein on 54 forearm in 47 patients from August 1995 to October 1999 (Male: 15, female: 32) with mean age 51 years (26 to 70 years).
RESULTS
The main cause of renal insufficiency were: diabetes 27 (57.4%), hypertensive 19 (40.4%), renal tuberculosis 2 (4.3%) and renal cyst 1 (2.1%). The waiting period before vascular access puncture has been 28 6 days. Eight (17.0%) stenosis has been detected and, forearm and/or hand edema occured in three (6.4%); thrombosis in two (4.3%); bleeding in two (4.3%); pseudoaneurysm in one. Through the follow-up periods of 50 months, the primary patency was 80.9% at 12 months and 78.7% at 24 months.
CONCLUSION
The brachio-basilic fistula with superficial transposition of basilic vein is a valuable vascular access for diabetes, female old patients, and can remain an alternative method for even younger patients by avoiding the installation of artificial graft after failed forearm arteriovenous fistula.

Keyword

Radiocephalic arteriovenous fistula; Transposed basilic vein; Arteriovenous fistula; ERDS (Endstage renal disease)

MeSH Terms

Aneurysm, False
Arteriovenous Fistula*
Consensus
Constriction, Pathologic
Edema
Female
Fistula
Follow-Up Studies
Forearm
Hand
Hemorrhage
Humans
Kidney Failure, Chronic
Ocimum basilicum*
Punctures
Renal Dialysis*
Renal Insufficiency
Thrombosis
Transplants
Tuberculosis, Renal
Veins*
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