The upper arm AV hemoaccess: long term follow-up.

Area of Science:

• Vascular Surgery
• Nephrology
• Dialysis Access

Background:

• End-stage renal disease (ESRD) necessitates reliable vascular access for hemodialysis.
• Arteriovenous fistulas (AVFs) are the preferred form of vascular access due to their longevity and lower complication rates.
• The basilic vein transposition technique for upper arm AVFs is a well-established procedure.

Purpose of the Study:

• To review the technique of creating an upper arm fistula by transposing the basilic vein to the brachial artery.
• To evaluate the long-term functional patency and complication rates of this specific AVF technique.
• To highlight the advantages of this method for creating durable hemodialysis access.

Main Methods:

• Review of the surgical technique involving end-to-side anastomosis of the transposed basilic vein to the brachial artery.
• Analysis of functional patency rates at an eight-year follow-up.
• Assessment of associated complications and their management.

Main Results:

• The functional patency rate at eight years was 70 percent.
• Complications associated with this angioaccess were minimal and easily managed.
• The technique demonstrated excellent flow and long functional patency.

Conclusions:

• The transposed basilic vein to brachial artery upper arm fistula is a safe and effective method for long-term hemodialysis access.
• Advantages include surgical simplicity, use of autologous vein, preserved axillary vein continuity, and a superficial, high-flow access.
• This technique offers a favorable alternative with a high patency rate and manageable complications.