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Varicose veins, or varicosities, develop when the valves in the veins, which control blood flow, weaken or damage. It causes blood to pool and the veins to enlarge. Understanding the clinical manifestations, diagnostic approaches, and management options for varicose veins is crucial for effective treatment and relief.Clinical manifestationsClinical manifestations of varicose veins include a heavy, achy feeling or pain after prolonged standing or sitting. This discomfort can often be relieved by...
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Two-Stage Basilic Vein Transposition: Second Stage Results.

Duarte Rego1, Clara Nogueira1, António Matos1,2

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Therapeutic Apheresis and Dialysis : Official Peer-Reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy
|October 31, 2017
PubMed
Summary

Transposed basilic vein arteriovenous fistulas offer good patency for hemodialysis access. Despite higher complexity and complication rates than some alternatives, they remain a viable option for patients needing vascular access.

Keywords:
Arteriovenous fistulaBasilic vein transpositionHemodialysis access

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Area of Science:

  • Vascular Surgery
  • Nephrology
  • Dialysis Access

Background:

  • Increasing hemodialysis patient survival depletes superficial veins, necessitating alternative access options.
  • Basilic vein transposition (BVT) is an alternative to arteriovenous grafts, despite concerns about complexity and maturation time.

Purpose of the Study:

  • To review the outcomes of a series of basilic vein transpositions (BVT) for hemodialysis access.
  • To evaluate patency and complication rates of BVT procedures.

Main Methods:

  • Retrospective review of 276 basilic vein transposition procedures performed between September 2005 and November 2012.
  • Two-stage BVT protocol involving fistula creation followed by vein transposition via small incisions.
  • Direct arterialization of the basilic vein was required for all procedures.

Main Results:

  • Usage rate was 82.2%, with 8% of fistulas experiencing thrombosis.
  • Secondary patency rates at 1 and 2 years were 84% and 66.3%, respectively.
  • Complications occurred in 61.6% of fistulas, with vein stenosis being the most frequent late complication (39.7%).

Conclusions:

  • Transposed basilic vein provides good patency rates for hemodialysis access.
  • While complication rates are significant, they are comparable or lower than other access methods like central venous catheters or prosthetic grafts.
  • BVT is a supported option for hemodialysis access, particularly after brachiocephalic fistula failure.