Ulnar-basilic fistula: indications, surgical aspects, puncture technique, and results

Ulnar-basilic fistula (UBF) is an autogenic vascular access option for hemodialysis (HD) first reported in 1967. However, only a few reports dealing with its complications and survival rates have been published in the literature. In the present work the results of 61 UBFs done in 60 adult patients on chronic HD are reported. Forty UBFs were created as primary access and the remaining 21 UBF as secondary access after: (a) thrombosis of an ipsilateral radiocephalic fistula (RCF) in 6 cases, (b) thrombosis of a contralateral RCF in 7 cases, and (c) thrombosis of a brachiocephalic fistula in 2 cases. No episodes of surgical complications, arterial steal, or ulnar nerve damage were observed. Five UBFs thrombosed within the first week after surgery. The 1-, 3-, and 5-year unassisted survival rates were 70.9%, 67.7%, and 57.3%, respectively, which were significantly higher than those reported previously. The inclusion of UBF in routine access plans is recommended.