S J F Harper1, I Goncalves, T Doughman, M L Nicholson. 1. Department of Infection, Immunity and Inflammation, Transplantation Division, University of Leicester, Leicester, UK. sjfharper@hotmail.com
Abstract
OBJECTIVES: The expanding haemodialysis population has lead to increased requirement for more complex vascular access. The aim of this study is to present the results of an extensive series of brachiobasilic arteriovenous fistulae. METHODS: BBAVF were performed using single-stage vein transposition. A retrospective review of case notes was performed. RESULTS: One hundred and sixty eight BBAVF were created in 144 patients. This was the first access procedure in only 30 cases and the fourth or fifth in 30. At 24h, 165 fistulas (98%) were patent. One hundred and eleven fistulas (66%) were used for haemodialysis and 57 (34%) were never used, of which 39 (23%) were due to fistula failure. The cumulative secondary patency at 1, 2 and 3 years was 66%, 50% and 41% respectively. There were 201 complications in 119 patients (71%), including thrombosis (29%), arm oedema (17%), infection (13%) and arterial steal syndrome (11%). Ten angioplasties and 48 operative procedures were performed for complications. Pre-operative ipsilateral subclavian catheter had been placed in 62 cases (37%) and was associated with poor patency. CONCLUSIONS: BBAVF represents an important option for vascular access with acceptable patency rates, although complication rates remain significant.
OBJECTIVES: The expanding haemodialysis population has lead to increased requirement for more complex vascular access. The aim of this study is to present the results of an extensive series of brachiobasilic arteriovenous fistulae. METHODS:BBAVF were performed using single-stage vein transposition. A retrospective review of case notes was performed. RESULTS: One hundred and sixty eight BBAVF were created in 144 patients. This was the first access procedure in only 30 cases and the fourth or fifth in 30. At 24h, 165 fistulas (98%) were patent. One hundred and eleven fistulas (66%) were used for haemodialysis and 57 (34%) were never used, of which 39 (23%) were due to fistula failure. The cumulative secondary patency at 1, 2 and 3 years was 66%, 50% and 41% respectively. There were 201 complications in 119 patients (71%), including thrombosis (29%), arm oedema (17%), infection (13%) and arterial steal syndrome (11%). Ten angioplasties and 48 operative procedures were performed for complications. Pre-operative ipsilateral subclavian catheter had been placed in 62 cases (37%) and was associated with poor patency. CONCLUSIONS:BBAVF represents an important option for vascular access with acceptable patency rates, although complication rates remain significant.
Authors: Khalid Bashar; Donagh A Healy; Sawsan Elsheikh; Leonard D Browne; Michael T Walsh; Mary Clarke-Moloney; Paul E Burke; Eamon G Kavanagh; Stewart R Walsh Journal: PLoS One Date: 2015-03-09 Impact factor: 3.240