Comparison among Transposed Brachiobasilic, Brachiobrachial Arteriovenous Fistulas and Flixene™ Vascular Graft

Lioupis, Christos; Mistry, Hiren; Rix, Tom; Chandak, Pankaj; Tyrrell, Mark; Valenti, Domenico

doi:10.5301/jva.2010.6065

Cited by 45 publications

(49 citation statements)

References 30 publications

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“…Diversely from recent reports any local infection was recorded in both groups in this study (5)(6)(7)(8)(9). All patients underwent hemodialysis in our institutional hemodialysis centre by the same nurse team.…”

Section: Discussionmentioning

confidence: 99%

“…Basilic vein transpositions (BVT), radio-basilic and brachio-brachial vein synthetic or biological bridge graft interposition are some of the other surgical vascular access procedures. BVT does not require a graft and has satisfactory outcome, however this technique is a bit challenging surgical procedure compared with graft interposition surgery and needs larger incision on the arm and longer time for maturation (4,5). Interpositioning of a bridge graft between upper arm artery and basilic/brachial veins is the other method which was performed either with synthetic or biological grafts.…”

Section: Discussionmentioning

confidence: 99%

“…An arterio-venous bridge graft by native and/or prosthetic graft is another alternative. Autologous saphenous vein is commonly preferred as the bridge graft between brachial/radial artery and basilic vein either in straight or loop fashion due its resistance to the infection and satisfactory patency compared with prosthetic grafts such as polytetraflouroethylene (PTFE) (3,5,6).…”

Section: Introductionmentioning

confidence: 99%

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Long-term patency of autogenous saphenous veins vs. PTFE interposition graft for prosthetic hemodialysis access

Uzun¹,

Diken²,

Yalçınkaya³

et al. 2014

Anadolu Kardiyol Derg

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Objective: Prosthetic vascular access is the other choice when the superficial venous system is inadequate to perform a simple radio-cephalic and brachio-cephalic fistula. Methods: This paper reports the outcomes of a prospective cohort study of 54 patients who underwent either saphenous vein (SVI Group, n=29) or PTFE graft (PTFE Group, n=25) interposition surgery for prosthetic hemodialysis access. All patients were evaluated via color Doppler ultrasonography during preoperative course and superficial venous systems of these patients were found inadequate to perform simple radial/ brachial artery-cephalic vein anastomosis. Follow-up was performed for every 6-months period. Kaplan-Meier analysis and Log Rank test was used for estimation and comparison of the patency. Results: In SVI group access failure was observed in 5 of 29 patients (17.2%). In PTFE group, access failure was observed in 13 of the 25 patients (52%). Primary patency rate was 93% in 12 th month and 82% in 24 th month in SVI group while it was 88% in 12 th month and 56% in 24 th month in PTFE group. According to the Kaplan-Meier method, mean time of primary patency was significantly higher in SVI group when compared to PTFE group (33.03±1.32 months vs. 28.16±1.91 months, Log Rank chi-square value: 7.01, df:1, p=0.008). Secondary patency rate was 96% in 12 th month and 93% in 24 th month for SVI group while 96% in 12 th month and 84% in 24 th month for PTFE group. According to the Kaplan-Meier method, mean time of secondary patency was significantly higher in SVI group when compared to PTFE group (34.27±0.95 months vs. 31.16±1.40 months, Log Rank chi-square value: 7.33, df:1, p=0.007). Conclusion: Autologous saphenous vein can be preferably chosen as a prosthetic hemodialysis access graft due its higher primary and secondary patency, lower complication rate and cost when compared with PTFE grafts. (Anadolu Kardiyol Derg 2014; 14: 542-6)

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Long-term patency of autogenous saphenous veins vs. PTFE interposition graft for prosthetic hemodialysis access

Uzun¹,

Diken²,

Yalçınkaya³

et al. 2014

Anadolu Kardiyol Derg

View full text Add to dashboard Cite

show abstract

“…23 This coupled with poorer outcomes from BBF in the patients over 60 years old 24 may favour a watchful waiting approach to these patients access creation. Perhaps early cannulation grafts 25,26 have a role in this subgroup of patients to permit avoidance of TCVCs but also minimize the morbidity associated with unnecessary access procedures. Such strategies would, however, need to be further evaluated given the high re-intervention rate required to maintain long-term patency of arteriovenous grafts.…”

Section: Utilization Of Avfmentioning

confidence: 99%

Brachiobasilic fistulae: an upper limb autologous option for everyone?

et al. 2016

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Purpose Autologous arteriovenous fistulae (AVF) are the vascular access option of choice. However, Brachiobasilic fistula (BBF) are complex procedures with variable outcomes reported in the literature. Our aim was to evaluate outcomes and morbidity associated with BBF in our population. Methods Retrospective analysis of prospectively collected data was undertaken for all 51 BBF created in our institution between January 2010 and March 2013. These were compared to an age and sex-matched group of brachiocephalic fistula (BCF) created over a similar time period. Demographic, operative and outcome data was collected for all patients. The primary end points were primary functional patency, primary-assisted patency and secondary patency at 3, 6 and 12 months. Continuous data was compared using Student's t-test and categorical data using chisquared test (p50.05 is significant). Results Mean patient age was 57 years (range: 21-82). About 45% were male. About 73% of patients were already on hemodialysis (HD) at the time of BBF creation. BBF was the secondary or tertiary access procedure in 60.8% of patients (n ¼ 31). BBF were associated with significant operative burden with 82% of patients requiring a general anaesthetic and median hospital admission of 2 days (range: 1-4). About 75% had a single-stage procedure. About 23.5% (n ¼ 12) required operative revision (superficialization or anastomotic revision for stenosis). Patients with BBF spent an additional 3.45 days/year in hospital as a result of access related complications compared to 0.56 days/year in the BCF group. Primary-assisted patency at 3, 6 and 12 months was better in the BCF group than BBF group (86%, 72% and 48% vs. 71%, 59%, 33%, respectively; p50.01) Primary functional and secondary patency rates at 3, 6 and 12 months were 74%, 58% and 32% and 78%, 63% and 41%, respectively, with an average of 0.33 procedures per AVF to maintain patency (10 fistuloplasties, 4 IR thrombectomy and 3 surgical thrombectomy). About 32% (n ¼ 17) of BBF were never used for HD (seven patients had a patent AVF but did not require HD418 months following creation; nine failed to adequately mature and one patient refused second stage superficialization). Conclusions BBF are associated with a significant initial operative burden and higher complication and poorer patency rates than BCF. About one-third of BBF created in this series were never used. Given the morbidity associated with this procedure, careful consideration should be given to creation of BBF in pre-dialysis patients particularly those in whom the rate of decline in renal function is slow. ARTICLE HISTORY

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“…4 A number of early stick graft devices have been proposed as a permanent solution to obtain access within less than a week. However, initial results [5][6][7][8][9][10][11][12][13] have been mixed, with many nephrologists and nurses being reluctant to perform early puncture even though these grafts were designed for that purpose. The purpose of this study using the Flixene early cannulation prosthetic graft (Maquet-Atrium Medical, Hudson, NH) was threefold: to evaluate the safety of early cannulation, to assess implementation in a dialysis center, and to report midterm patency and complication rates.…”

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confidence: 99%