Comparison of autologous basilic vein transpositions between forearm and upper arm regions

Arteriovenous fistulas are crucial for hemodialysis performances in patients with end-stage renal disease. In this report, we compare the results of basilic vein transposition in the forearm and upper arm regions. Autologous basilic vein transpositions were used in 20 patients with end-stage renal failure between May 2000 and January 2002. In 10 cases the basilic vein transposition was in the upper arm region for construction of a brachiobasilic fistula (group 1); in the remaining 10 cases it was in the forearm region for creation of a radiobasilic fistula (group 2). The mean age of the patients in group 1 was 53.6 years, and in group 2 it was 47.3. At the end of the follow-up period (mean, 10 months) patency rates in group 1 were 80% and in group 2, 90%. In group 2, early-term thrombosis, which could be treated easily with second intervention and anticoagulation treatment (low-molecular-weight heparin), was the most common complication (10%). For patients who have unsuitable cephalic vein and require long-term hemodialysis, transposition of the basilic vein in the forearm region (under the elbow) can be a good secondary choice for access, as can a brachiobasilic fistula in the upper arm region.