Document Detail


Superficialization of the basilic vein technique in brachiobasilic arteriovenous fistula: surgical experience of 350 cases during 4 years period.
MedLine Citation:
PMID:  20471784     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The primary use of autogenous arteriovenous fistula for chronic hemodialysis patients is recommended by the National Kidney Foundation-Dialysis Outcomes Quality Initiative practice guidelines (Am J Kidney Dis 2001;37(1 Suppl. 1):S7-S64; Am J Kidney Dis 1997;30(4 Suppl. 3):S150-S191). Brachiobasilic arteriovenous fistula offers excellent access in difficult cases. Many surgical techniques have been described to create brachiobasilic fistula. The purpose of this study was to present and discuss the technique of superficialization of the basilic vein in brachiobasilic arteriovenous fistula with long-term results of 350 cases. METHODS: A total of 375 brachiobasilic arteriovenous fistulas were constructed with superficialization of the basilic vein technique. Of these, 350 fistulas were used in hemodialysis (93.3%). One hundred fifty-five (44%) patients were male, 195 (56%) were female. Mean age was 57.8 (range, 18-88) years. A 2-cm longitudinal incision was made in antecubital fossa to expose brachial artery and basilic vein under local anesthesia. A separate second skin incision (4-6 cm) was done to explore proximal part of the basilic vein. Side branches of the basilic vein were isolated and ligated carefully using this second skin incision. The basilic vein was divided in antecubital fossa and brought over the fascia through the subcutaneous tunnel at the same anatomical position. Anastomosis was performed with end-to-side technique. RESULTS: Mean follow-up was 48 months (range, 2-84). The mean time to first puncture and use of the fistula time was 52 days (range, 25-75). Bleeding required surgical exploration which occurred in 3 (0.9%) patients. Primary patency of basilic vein superficialization fistulas was 92%, 78%, 64%, and 54% at 1, 2, 3, and 4 years, respectively. Secondary patency was 93%, 81%, 66%, and 56% at 1, 2, 3, and 4 years, respectively. CONCLUSION: Superficialization of the basilic vein technique is a logical alternative method of the basilic vein transposition. Superficialization requires less extensive skin incision and surgical dissection. Long-term patency was good.
Authors:
Ali Kubilay Korkut; Mesut Kosem
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Publication Detail:
Type:  Journal Article     Date:  2010-05-14
Journal Detail:
Title:  Annals of vascular surgery     Volume:  24     ISSN:  1615-5947     ISO Abbreviation:  Ann Vasc Surg     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-19     Completed Date:  2010-10-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8703941     Medline TA:  Ann Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  762-7     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Cardiovascular Surgery, Yedikule Teaching and Research Hospital, Istanbul, Turkey. kubilaykorkut@superonline.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Arteriovenous Shunt, Surgical / methods*
Brachial Artery / physiopathology,  surgery*
Female
Graft Occlusion, Vascular / etiology,  surgery
Humans
Kaplan-Meiers Estimate
Male
Middle Aged
Renal Dialysis*
Reoperation
Time Factors
Treatment Outcome
Turkey
Upper Extremity / blood supply*
Vascular Patency
Veins / physiopathology,  surgery
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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