| Basilic vein transposition: what is the optimal technique? | |
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MedLine Citation:
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PMID: 20172751 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: To compare the outcome of the one-stage basilic vein transposition (BVT) fistula with a modified, two-stage technique. DESIGN: Retrospective case-controlled study, performed in an academic centre. MATERIAL: A total of 173 candidates for BVT fistula (87 males, mean age 61 years). METHODS: In one-stage BVT, the basilic vein is mobilised through a single incision, placed inside an anterolateral arm tunnel and anastomosed with the brachial artery. In two-stage procedures, the fistula-arterial anastomosis is created first, followed by the second stage, after fistula maturation several weeks later, when the basilic vein is mobilised through two skip incisions, transected near the anastomosis, placed inside an anterolateral arm tunnel and reanastomosed. Morbidity and fistula maturation rate were the main outcome measures. RESULTS: In one-stage BVT (n=76), the incidence of venous hypertension, wound haematomas and all complications (17%, 13% and 43%, respectively) was significantly higher than in two-stage procedures (n=98) (4%, p=0.004, 3%, p=0.012 and 11%, p<0.001, respectively). Time (68 days) to fistula use was significantly decreased in one-stage BVT than in two-stage procedures (132 days, p<0.001) but failure to mature rate was equivalent (15% vs. 18%, p=0.49). CONCLUSIONS: Our results indicate that the two-stage BVT fistula through two skip-arm incisions is superior to the established one-stage procedure in terms of less morbidity but at the cost of a second operation and longer time to access use. Further research comparing these two techniques is necessary. Until this issue is resolved, an individualised approach is suggested. |
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Authors:
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S K Kakkos; G K Haddad; M R Weaver; R K Haddad; M M Scully |
Publication Detail:
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Type: Comparative Study; Journal Article Date: 2010-02-20 |
Journal Detail:
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Title: European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery Volume: 39 ISSN: 1532-2165 ISO Abbreviation: Eur J Vasc Endovasc Surg Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-05-03 Completed Date: 2010-05-13 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9512728 Medline TA: Eur J Vasc Endovasc Surg Country: England |
Other Details:
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Languages: eng Pagination: 612-9 Citation Subset: IM |
Copyright Information:
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Copyright (c) 2010 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved. |
Affiliation:
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Division of Vascular Surgery, Department of Surgery, Henry Ford Hospital, K-8, 2799 W Grand Boulevard, Detroit, MI 48202, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Academic Medical Centers Aged Arm / blood supply* Arteriovenous Shunt, Surgical / adverse effects, methods* Brachial Artery / surgery Chi-Square Distribution Female Humans Logistic Models Male Michigan Middle Aged Odds Ratio Renal Dialysis* Reoperation Retrospective Studies Risk Assessment Risk Factors Time Factors Treatment Outcome Veins / surgery |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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