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. 2005 Oct;20(10):2168-71.
doi: 10.1093/ndt/gfh997. Epub 2005 Jul 19.

Excellent performance of one-stage brachial-basilic arteriovenous fistula

Xavier H A Keuter  1 , Frank M van der Sande, Alfons G Kessels, Michiel W de Haan, Arnold P G Hoeks, Jan H M Tordoir
Affiliations

Excellent performance of one-stage brachial-basilic arteriovenous fistula

Xavier H A Keuter et al. Nephrol Dial Transplant. 2005 Oct.

Abstract

Background: According to the National Kidney Foundation-Dialysis Outcomes Quality Initiative (NKF-DOQI) and the European Guidelines, the first and second choice for vascular access for haemodialysis are the radial-cephalic and brachial-cephalic arteriovenous fistula (AVF). Autogenous fistulas have a longer functional lifetime, less thrombotic complications and a lower infection risk compared with prosthetic implants. If it is impossible to create a brachial-cephalic AVF or after failure, either a brachial-basilic (BB) or a prosthetic forearm loop AVF may be considered. To determine the outcome of BB-AVFs, we retrospectively surveyed the results of this type of vascular access.

Methods: All BB-AVF patient records over a 6 year period were subtracted from an academic hospital registry. Primary failure and primary, assisted primary and secondary patency rates were calculated with the Kaplan-Meier method. Sex, diabetes mellitus (DM), pre-operative duplex diameters, complications and interventions were recorded and correlated with the patency rates.

Results: A total of 31 BB-AVFs were created in a one-stage surgical procedure. Of the patients, 36% were male and 19% had DM. Only one patient had a primary failure, leaving 30 (97%) of the BB-AVFs functional for dialysis treatment. Four patients died within 1 year after the operation, one of them from a catheter sepsis. Primary, assisted primary and secondary patency rates after 1 year were, 58, 83 and 90%, respectively. Patient characteristics and pre-operative duplex parameters did not influence patency rates.

Conclusion: The BB-AVF is an excellent third choice option for vascular access.

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