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Video-assisted basilic vein transposition for haemodialysis vascular access: preliminary experience with a new
J H Tordoir1, R Dammers, M de Brauw
1Department of Surgery, University Hospital Maastricht, Maastricht, The Netherlands.
Background:
The brachio-basilic vein arteriovenous (AV) fistula is increasingly used as a secondary method for haemodialysis vascular access. The conventional surgical technique of brachio-basilic vein AV fistula creation consists of a long incision with dissection of the basilic vein and transposition of it to a subcutaneous anterior position in the upper arm. The aim of this study was to investigate whether minimal invasive basilic vein dissection with an endoscopic technique is feasible.
Methods:
In 12 patients, brachio-basilic vein AV fistulas were created by means of a video-assisted technique with semi-closed dissection and harvesting of the basilic vein with the use of an endoscope and standard endoscopic instruments. All patients underwent pre- and post-operative duplex ultrasound investigation.
Results:
In all patients, a successful endoscopic dissection was possible without peri-operative complications. One patient suffered from post-operative thrombotic occlusion, which was successfully treated by thrombectomy. One patient developed a haematoma in the upper arm. No wound complications occurred and all AV fistulas could be used satisfactorily for dialysis treatment.
Conclusions:
Video-assisted basilic vein transposition is a feasible minimal invasive technique to create secondary vascular access for haemodialysis.