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Transposition of brachiobasilic arteriovenous fistulas: One‐stage or two‐stage technique and factors affecting the early maturation
Author(s) -
Ozhan Abdulkerim,
Memetoglu Mehmet Erdem,
Kehlibar Tamer,
Bastopcu Murat,
Yilmaz Mehmet,
Karakaya Canan,
Guler Erhan,
Ketenci Bulend
Publication year - 2021
Publication title -
therapeutic apheresis and dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.415
H-Index - 53
eISSN - 1744-9987
pISSN - 1744-9979
DOI - 10.1111/1744-9987.13610
Subject(s) - medicine , stage (stratigraphy) , arteriovenous fistula , brachial artery , basilic vein , surgery , univariate analysis , cephalic vein , fistula , vein , multivariate analysis , paleontology , blood pressure , biology
The brachiobasilic transposition (BBT) arteriovenous fistula (AVF) is a valuable option especially for dialysis patients with previously failed vascular access. We aim to report factors affecting the maturation of BBT‐AVF created with either one‐stage or two‐stage technique. BBT‐AVF procedures between January 2015 and May 2019 by a dedicated vascular access team were investigated retrospectively. A total of 122 patients (63 males, 59 females), with 6 to 12 weeks of follow‐up after the BBT‐AVF procedure were included in the study. Patients of one‐stage and two‐stage techniques were compared for maturation rates. Patients with successful and failed maturation were compared for baseline characteristics and anatomic factors. Of 122 BBT‐AVF procedures, 54 were created with the one‐stage and 68 were created with the two‐stage technique. The mean age of the patients was 58.2 ± 13.8, the mean brachial artery and basilic vein diameters were 3.91 ± 1.02 mm, and 3.39 ± 1.16 mm. Of 122 included patients, 88 (72.1%) had mature AVFs at follow‐up. The AVF maturation rates were similar between the one‐ and two‐stage groups (70.4% vs 73.5%; P = .699). Lower age (62.8 ± 12.5 vs 56.5 ± 13.9; P = .023) and greater brachial artery diameter (3.09 ± 0.84 mm vs 4.23 ± 1.76 mm; P < .048) were the only factors affecting the AVF maturation in univariate analysis. Gender, extremity side, diabetes mellitus, hypertension, and targeted vein diameter were not found to affect the AVF maturation ( P = .301, P = .084, P = .134, P = .858, P = .127). Target artery diameter ( P = .049) was the only significant factor affecting BBT‐AVF maturation in multivariate analysis. One‐stage and two‐stage BBT‐AVFs are similar in terms of maturation rates. Targeted artery diameter was the only factor important in BBT‐AVF maturation in our study group. The two‐stage technique can be preferred considering smaller incision size and lower complication rate in patients with suitable anatomy.