A Systematic Review and Meta-Analysis of Randomized Trials Comparing Two-Stage with One-Stage Brachio-Basilic Vein Fistulas

Kakkos, Stavros K.; Lampropoulos, George; Nikolakopoulos, Konstantinos M.; Tsolakis, Ioannis A.; Papadoulas, Spyros; Papachristou, Evangelos; Goumenos, Dimitrios; Lazarides, Miltos K.

doi:10.5758/vsi.2018.34.3.51

Cited by 5 publications

(6 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…3 A relationship between AVF maturation and vein diameter has been reported, but arterial diameter has not been extensively studied for its effect on maturation. 8,[16][17][18] Our results did not show vein diameter to be a significant factor for AVF maturation. Kakkos meta-analysis that the one-stage technique was associated with a higher failure to mature, which was not observed in previous retrospective studies.…”

Section: Discussioncontrasting

confidence: 66%

“…To better answer the question of which technique is better in terms of maturation, more randomized controlled trials may be necessary to avoid any selection bias. 17 According to the Vascular Access 2018 Clinical Practice Guidelines of the European Society of Vascular Surgery, a minimum arterial and venous internal diameter of 3 mm is recommended for BBT-AVF. 3 While a minimum of 3 mm is sought for arterial diameter in cases where BBT-AVF is planned, the decision for one or two stage technique can be influenced by vein diameter.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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

Özhan¹,

Memetoğlu²,

Kehlіbar³

et al. 2021

Ther Apher Dial

View full text Add to dashboard Cite

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 followup 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 < .048) were the only factors affecting the AVF maturation in univariate analysis. Gender, extremity side, diabetes mellitus, hypertension, and targeted vein diameter were not found to affect the AVF maturation (P = .301, P = .084, P = .134, P = .858, P = .127). Target artery diameter (P = .049) was the only significant factor affecting BBT-AVF maturation in multivariate analysis.One-stage and two-stage BBT-AVFs are similar in terms of maturation rates.Targeted artery diameter was the only factor important in BBT-AVF maturation in our study group. The two-stage technique can be preferred considering smaller incision size and lower complication rate in patients with suitable anatomy.

show abstract

Section: Discussioncontrasting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

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

Özhan¹,

Memetoğlu²,

Kehlіbar³

et al. 2021

Ther Apher Dial

View full text Add to dashboard Cite

show abstract

“…There are three good meta-analyses and one review of prospective randomized trials existent today (obviously covering many of the same reports, with increasing numbers as the years progressed). 10–13 Bashar et al reviewed four manuscripts, finding similar maturation and complication rates in both groups. Cooper et al brought this to 8, also concluding that maturation and primary patency rates were no different.…”

Section: Discussionmentioning

confidence: 93%

“…8,9 Although four meta-analyses have been published, the reports cited are conflicting. 10–13 This report is designed to objectively review the published literature to determine whether either strategy is conclusively better than the other, and to provide supportive data for a randomized trial.…”

Section: Introductionmentioning

confidence: 99%

One- versus two-stage transposed brachiobasilic arteriovenous fistulae: A review of the current state of the art

et al. 2019

View full text Add to dashboard Cite

In the absence of suitable cephalic vein, the brachiobasilic vein complex represents the best option for arteriovenous access. However, the basilic vein is too deep to cannulate and requires transposition to be accessible. Transposition can be performed during fistula creation (single-stage BBTx) or at a second operation after initial fistula creation (two-stage brachiobasilic transposition (BBTx)). The best approach is unknown. A PubMed search using “Basilic vein transposition” as the primary search term was performed to identify articles addressing this controversy. Meta-analysis was then performed using those papers that provided the inspected data points with student’s t-test used to compare maturation and patency rates between the groups. A total of 37 manuscripts were judged of adequate quality for analysis. Based on the available data, overall maturation rates, 1-year primary patency rates, and overall complication rates seem to be equivalent between single- and two-stage BBTx, while 1-year secondary patency is greater in the two-stage group (79% vs 85%). A large prospective randomized clinical trial with clear definitions of maturity, patency, and complications is needed to definitively answer the question of whether one strategy is better than the other.

show abstract

“…In most cases, the basilic vein from the superficial network is used; however, in some patients, the brachial vein may represent the only viable option. 4 In 1983, Koontz and Helling proposed the use of the brachial vein as a fistula conduit 5 and, in 2004, Bazan and Schanzer described the superficialisation of the brachial vein. 6…”

Section: Introductionmentioning

confidence: 99%

A systematic review of the brachial vein arteriovenous fistulas as a viable option for haemodialysis access

Gavriilidis

Papalois

2020

J Vasc Access

View full text Add to dashboard Cite

Objectives: International guidelines recommend the use of autogenous vascular access. Where suitable superficial veins are unavailable deeper veins may be used as an option. In most cases, basilic veins are used when cephalic veins are unavailable; arteriovenous fistulas using the brachial vein from the deep venous network are rare. Therefore, the purpose of the present study was to conduct a systematic review of the available literature evaluating the use of the brachial vein in arteriovenous fistulas. Methods: Systematic literature search of electronic databases in accordance with PRISMA was conducted. The primary outcomes of this study were primary and secondary patency rates for brachial vein arteriovenous fistulas; the secondary outcomes were the rates of access thrombosis, steal syndrome, pseudo-aneurysm and infection. Results: The 1-year primary, assisted, and secondary patency was recorded at (24%–77%), (45%–85%) and (45%–96%), respectively. The 2-year primary, assisted and secondary patency rate was recorded at (12%–46%), (19%–75%) and (19%–92%), respectively. However, the consistency regarding the reports and definitions used were highly variable. The incidence rate of infection, thrombosis and steal syndrome was 5% (0%–12%), 15.9% (9.5%–35%) and 3% (2%–6%), respectively. Conclusion: Available studies support the use of brachial veins as a reliable access option in patients with non-accessible superficial veins where an autologous option is required.

show abstract

A Systematic Review and Meta-Analysis of Randomized Trials Comparing Two-Stage with One-Stage Brachio-Basilic Vein Fistulas

Cited by 5 publications

References 22 publications

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

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

One- versus two-stage transposed brachiobasilic arteriovenous fistulae: A review of the current state of the art

A systematic review of the brachial vein arteriovenous fistulas as a viable option for haemodialysis access

Contact Info

Product

Resources

About