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Utility of basilic vein transposition for dialysis access
Hosam F El Sayed1, Bernardo Mendoza, George H Meier
1Vascular Surgical Division, Eastern Virginia Medical School, Norfolk, USA.
Vascular
|November 18, 2005
Summary
Basilic vein transposition (BVT) provides a durable autologous access for hemodialysis, particularly when other options are limited. While patency rates require interventions, BVT remains a valuable option for long-term dialysis success.
Area of Science:
- Vascular Surgery
- Nephrology
- Dialysis Access
Background:
- Autologous arteriovenous access is crucial for successful long-term hemodialysis, as recommended by NKF's DOQI guidelines.
- Basilic vein transposition (BVT) offers a durable conduit with high patency and maturation rates, addressing the need for reliable hemodialysis access.
Purpose of the Study:
- To evaluate the outcomes of Basilic vein transposition (BVT) as an autologous arteriovenous access for hemodialysis.
- To assess the functional assisted patency rates and secondary interventions required for BVT.
Main Methods:
- Retrospective review of 170 Basilic vein transposition (BVT) procedures in 162 patients between November 1992 and October 2001.
- Functional assisted patency was the primary endpoint; telephone interviews supplemented clinical data.
- Secondary interventions were not considered detrimental if the access remained patent and in use.
Main Results:
- Functional assisted patency was 40.0% at 2 years and 15.2% at 5 years, with a mean assisted patency of 14.6 months.
- 40 percutaneous interventions and 18 surgical revisions were performed in 32 patients (19.0%) to maintain patency.
- Complications included ligation for swelling in 2.5% and steal syndrome in 1.9% of patients.
Conclusions:
- Basilic vein transposition (BVT) is a valuable autologous procedure for hemodialysis, especially for patients lacking adequate cephalic veins.
- Despite lower patency compared to conventional procedures, BVT is a durable and often the only available autologous option for hemodialysis access.
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