Modified two-stage basilic vein transposition for hemodialysis access

Background

Various techniques for basilic vein transposition have been described, including endovascular, 1-stage, and 2-stage transposition. However, none of these 2-stage techniques include a new arteriovenous anastomosis during the second stage. This study adds to the current literature as well as introducing a new and innovative technique for hemodialysis access.

Methods

Forty-nine basilic vein transpositions were performed. Data were collected retrospectively. Primary and secondary patency was calculated using life table methods. Complications and interventions were recorded.

Results

Primary patency was 72% at 1 year, 54% at 2 years, and 54% at 3 years. Secondary patency was 95%, 80% and 65% at 1, 2, and 3 years, respectively. Twenty-nine patients experienced complications related to the fistula, and 15 required intervention to maintain patency. Patency was achieved in 100% of the procedures using percutaneous techniques.

Conclusions

This 2-stage procedure should be strongly considered when planning brachial basilic fistulas for hemodialysis access.