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

Sheta, Mohamed; Hakmei, Jalal; London, Mark; Wooster, Mathew; Aruny, John E.; Ross, John; Illig, Karl A.

doi:10.1177/1129729819862694

Cited by 12 publications

(18 citation statements)

References 41 publications

(58 reference statements)

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“…In this study, the early thrombosis rate was 18.8% [13]. In a meta-analysis by Sheta et al, primary patency rates for BVTAVF were found to be approximately 85% [14]. In the literature review, the primary patency rate of primary fistulas was found to be 75% to 90.3% [12][13][14].…”

Section: Discussionmentioning

confidence: 52%

“…In a meta-analysis by Sheta et al, primary patency rates for BVTAVF were found to be approximately 85% [14]. In the literature review, the primary patency rate of primary fistulas was found to be 75% to 90.3% [12][13][14]. In our study, the percentages of primary patency rates at 3, 6, 9, 12, and 24 months were 96.6%, 93.1%, 92%, 87.4%, and 82.8% in BCAVF patients, and 96.7%, 93.3%, 90%, 86.7%, and 80% in BVTAVF patients, respectively.…”

Section: Discussionmentioning

confidence: 99%

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Proximal Arteriovenous Fistulas in Hemodialysis Patients: Advantages and Disadvantages

Güven

Uludağ

2020

Cureus

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Introduction: The main objective of the present study is to investigate the advantages and disadvantages of proximal arteriovenous native fistulas. Hemodialysis is indispensable for patients with end-stage renal disease. For this purpose, arteriovenous fistulas (AVFs) are used. Among the native fistulas, distal radiocephalic AVF is the most preferred. However, brachiocephalic AVF (BCAVF) and brachiobasilic AVF with basilic vein transposition (basilic vein transposition arteriovenous fistula [BVTAVF]) can be used for a long time in dialysis patients whose distal vascular bed is depleted. Methods: This is a retrospective study of 117 AVFs (BCAVF and BVTAVF), in patients with end-stage chronic renal disease, that were opened with a surgical technique (2012-2018). The postoperative two-year patency rates, AVF locations, complications, and the advantages and disadvantages of these fistulas are reviewed and recorded in the light of the literature. Results: The mean age of the patients (52 men and 65 women) was 60.6 ± 13.6 years. The percentages of primary patency rates at 3, 6, 9, 12, and 24 months were 96.6%, 93.1%, 92%, 87.4%, and 82.8% in BCAVF patients, and 96.7%, 93.3%, 90%, 86.7%, and 80% in BVTAVF patients, respectively. The percentages of secondary patency rates at 6, 12, and 24 months were 100%, 93.3%, and 86.7% in BCAVF patients, and 100%, 100% and 87.7% in BVTAVF patients, respectively. Fistula thrombosis was seen as the most common complication. The early complication was bleeding/hematoma. As late complications, we encountered steal syndrome, ischemic pain in the relevant extremity, pseudoaneurysm, and high-output heart failure. Conclusion: Proximal AVFs are preferable fistulas with early maturation and high primary patency rates. We believe that relatively high complications can be avoided by opening fistulas with an appropriate surgical technique.

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Section: Discussionmentioning

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Proximal Arteriovenous Fistulas in Hemodialysis Patients: Advantages and Disadvantages

Güven

Uludağ

2020

Cureus

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“…In another meta-analysis by Sheta et al, 37 studies on one-stage versus two-stage BBAVF were evaluated. The one-year primary patency rates and incidence of complications were equivalent between the two procedures [ 19 ]. However, the secondary patency rate at one year was higher in the two-stage technique (79% versus 85%).…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Transposition of Brachiobasilic Arteriovenous Fistula in Two-Stage Technique: A Single-Centre Experience With Literature Review

Mehra¹,

Manikandan²,

Dorairajan³

et al. 2020

Cureus

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Introduction Arteriovenous fistulae (AVF) are considered a better option for long-term dialysis access. The distal radiocephalic AVF is the most preferred followed by proximal radiocephalic, brachiocephalic and brachiobasilic AVFs (BBAVF) with basilic vein transposition. In case of failure of AVF at other anatomical locations, BBAVF may improve the outcomes for patients needing dialysis for long term. The two-stage technique of BBAVF has easier dissection and lesser devascularisation risk. The disadvantages are need for two interventions and delay in maturation. Materials and Method It was a retrospective observational study including 42 patients who underwent transposition of BBAVF as two-stage procedure from June 2014 to July 2018. The data recorded were demographic characteristics, such as median age, gender, dialysis status at AVF creation and operative duration. Complications like postoperative limb oedema, bleeding and thrombosis of AVF were recorded. Patency and access outcome of AVF were documented at three-month follow-up. Results Among 42 patients, 27 (64.3%) were males. The median age was 50 years. Around 14% of patients had minor complications like oedema. Eight (19%) patients needed re-exploration due to bleeding or thrombosis. The early access failure rate that is a failure before discharge was 4.7%. The patency rate at three months was 90.5%, but the primary functional rate was 74%. Conclusion Transposition of BBAVF as a two-step technique is associated with reasonable patency rate and primary functional rate. The related complications were low, and a good number of fistulae could be saved with timely intervention.

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“…Authors emphasize that maturation, patency, failure and complication rates may suggest equivalence of both techniques. However, it is also emphasized that the strength of the evidence is limited [13,[15][16][17]. Some authors report that the one-stage technique decreases the time of maturation and the time to the first cannulation.…”

Section: One-stage Basilic Vein Tunneled Transposition For Hemodialysmentioning

confidence: 99%

One-stage basilic vein tunneled transposition for hemodialysis access

Sułkowski¹,

Osuch²,

Matyja³

et al. 2021

Arch Med Sci Civil Dis

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

Cited by 12 publications

References 41 publications

Proximal Arteriovenous Fistulas in Hemodialysis Patients: Advantages and Disadvantages

Proximal Arteriovenous Fistulas in Hemodialysis Patients: Advantages and Disadvantages

Outcomes of Transposition of Brachiobasilic Arteriovenous Fistula in Two-Stage Technique: A Single-Centre Experience With Literature Review

One-stage basilic vein tunneled transposition for hemodialysis access

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