Journal Article

Excellent performance of one-stage brachial–basilic arteriovenous fistula

Xavier H. A. Keuter, Frank M. van der Sande, Alfons G. Kessels, Michiel W. de Haan, Arnold P. G. Hoeks and Jan H. M. Tordoir

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 20, issue 10, pages 2168-2171
Published in print October 2005 | ISSN: 0931-0509
Published online July 2005 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfh997
Excellent performance of one-stage brachial–basilic arteriovenous fistula

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Background. According to the National Kidney Foundation-Dialysis Outcomes Quality Initiative (NKF-DOQI) and the European Guidelines, the first and second choice for vascular access for haemodialysis are the radial–cephalic and brachial–cephalic arteriovenous fistula (AVF). Autogenous fistulas have a longer functional lifetime, less thrombotic complications and a lower infection risk compared with prosthetic implants. If it is impossible to create a brachial–cephalic AVF or after failure, either a brachial–basilic (BB) or a prosthetic forearm loop AVF may be considered. To determine the outcome of BB-AVFs, we retrospectively surveyed the results of this type of vascular access.

Methods. All BB-AVF patient records over a 6 year period were subtracted from an academic hospital registry. Primary failure and primary, assisted primary and secondary patency rates were calculated with the Kaplan–Meier method. Sex, diabetes mellitus (DM), pre-operative duplex diameters, complications and interventions were recorded and correlated with the patency rates.

Results. A total of 31 BB-AVFs were created in a one-stage surgical procedure. Of the patients, 36% were male and 19% had DM. Only one patient had a primary failure, leaving 30 (97%) of the BB-AVFs functional for dialysis treatment. Four patients died within 1 year after the operation, one of them from a catheter sepsis. Primary, assisted primary and secondary patency rates after 1 year were, 58, 83 and 90%, respectively. Patient characteristics and pre-operative duplex parameters did not influence patency rates.

Conclusion. The BB-AVF is an excellent third choice option for vascular access.

Keywords: brachial–basilic arteriovenous fistula; haemodialysis; retrospective study; vascular access patency

Journal Article.  2005 words.  Illustrated.

Subjects: Nephrology

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