Modified Brachio-basilic/brachial Arteriovenous Fistula Creation with Short-segment Elevation Preserving the Axilla

Kim, Min Seob; Min, Sang Il; Ahn, Sungyoon; Kim, Hyunyoung G.; Choi, Chanjoong; Mo, Hyejin; Han, Ahram; Ha, Jong‐Won

doi:10.1016/j.avsg.2020.02.037

Cited by 2 publications

(2 citation statements)

References 35 publications

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“…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: 58%

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

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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.

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Section: Discussioncontrasting

confidence: 58%

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

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“…Although there were a high possibility of cannulation in scar tissue, but a questionnaire for dialysis nurses conducted in our previous study showed that scar tissue had noninferiority compared with normal tissue during cannulation. 3 Our methods were distinguished from the conventional methods requiring a lateral side subcutaneous pocket and long segment for transposition. 4,5 We used a 4-6 mm expanded polytetrafluoroethylene (ePTFE) graft (Gore-Tex, WL Gore & Associates, Flagstaff, Ariz) for all AVGs.…”

Section: Techniquementioning

confidence: 99%

Comparison between autogenous brachial–brachial upper-arm elevated direct arteriovenous fistulas and prosthetic brachial-antecubital indirect forearm arteriovenous grafts

et al. 2021

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Objectives: The National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF-KDOQI) guidelines recommend forearm arteriovenous grafts (AVGs) as an alternative procedure to transposed basilic vein fistulas for providing secondary access during hemodialysis. Recently, autogenous elevated brachial-brachial vein fistulas (BVE) have become increasingly popular. The aim of this study was to compare the outcomes of BVE and forearm loop AVG (AVG) for secondary access in hemodialysis. Methods: We retrospectively reviewed the medical records of patients who had received a BVE or forearm AVG at a single center from January 2015 to April 2019. In total, 19 BVE were created via two-stage operations and two via a one-stage operation; 53 forearm AVG’s were performed. Results: The AVG group was twice as likely to suffer loss of primary patency compared with the BVE group (odds ratio [OR], 2.666; 95% confidence interval [CI], 1.108–6.412; p = 0.029) per the multivariate analysis. The primary patency and primary assisted patency of the BVE group were superior those of the AVG group, except for secondary patency ( p = 0.02, p = 0.07, p = 0.879, respectively). In subgroup analysis, there were no significant differences in primary, primary assisted, or secondary patency between AVG and BVE when brachial vein was used for AVG outflow. In addition, no significant differences were noted regarding the infection rate (12.5% vs 12.3%, p = 0.331, severity >0), postoperative bleeding rate (14.5% vs 3.5%, p = 0.191, severity >1), early thrombus rate (0.0% vs 10.5%, p = 0.122), and early failure rate (7% vs 4.8%, p = 0.591). Conclusions: The primary patency and primary assisted patency rates of BVE were significantly better than those observed in AVGs, but the complication rates were similar. The appropriate procedure to provide vascular access should be determined by the individual patient’s condition and the surgical skill of the operating surgeon.

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Modified Brachio-basilic/brachial Arteriovenous Fistula Creation with Short-segment Elevation Preserving the Axilla

Cited by 2 publications

References 35 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

Comparison between autogenous brachial–brachial upper-arm elevated direct arteriovenous fistulas and prosthetic brachial-antecubital indirect forearm arteriovenous grafts

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