The Brachio-Brachial Arteriovenous Fistula: Mid-Term Results

Abstract

Objective To evaluate the mid-term results of the brachio-brachial arteriovenous fistula in patients without adequate superficial venous circulation in the upper limb. Methods Retrospective analysis included 49 patients, in whom a brachio-brachial fistula had been created in an end-to-side configuration. After the maturation period (1 month), the brachial vein was transposed into the subcutaneous tissue. Follow-up study was performed in patients with functional brachio-brachial fistula after the superficialization. Results Forty-nine patients underwent 49 brachio-brachial fistula constructions. All fistulas were functional. One month after surgery, 40 (81.6%) of these patients had a functional fistula, but in only 39 (79.6%) cases was the fistula suitable for hemodialysis (HD) following transposition to subcutaneous tissue. During the 1–month maturation period, the fistula became occluded in nine patients, and in one case the vein was permeable, so the fistula was functional, but too small to permit HD. Seventeen patients developed temporary edema of the forearm during the first month, in three cases the edema was extended to the entire arm, but no other complications were associated with the procedure. Follow-up lasted 18.0 ± 11.1 (3–37) months, during which 7/39 patients presented with fistula occlusion. Three patients died and another three were out of the study for various reasons. Conclusions the brachio-brachial fistula is a good alternative to prosthetic grafts in patients without superficial venous circulation in the upper limb.

Our experience in using the brachial venae comitantes as a native vascular access for hemodialysis

“…Furthermore, diabetes mellitus and hypertension, which were present in most subjects in our cohort, could contribute to poorer surgical wound healing. When comparing with previous studies, we noticed that larger cohorts were associated with better outcomes . Therefore, we feel that with experience, we would be able to improve our outcomes.…”

“…When comparing with previous studies, we noticed that larger cohorts were associated with better outcomes. 11,12 Therefore, we feel that with experience, we would be able to improve our outcomes.…”

The Brachio-Brachial Arteriovenous Fistula

“…Between 2004 and 2007 our team has operated on 49 patients with an upper arm venous system unsuitable for long term hemodialysis access, creating 49 brachio-brachial fistulas (Dorobantu et al, 2010). To date, this is the largest reported cohort of patients with a brachio-brachial AVF.…”

Hemodialysis vascular access options after failed Brescia-Cimino arteriovenous fistula

“…reported their mid-term results in 49 patients in whom brachiobrachial AVF was constructed in two stages. [22] One month after surgery, 40 (81.6%) of these patients had a functional fistula, but in only 39 (79.6%) cases was the fistula suitable for HD following transposition to the subcutaneous tissue. Seventeen patients developed temporary edema of the forearm during the first month, in three cases the edema extended to the entire arm, but no other complications were associated with the procedure.…”