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Long‐term outcomes of transposed basilic vein arteriovenous fistulae
Author(s) -
MOOSSAVI Shahriar,
TUTTLE Audrey B.,
VACHHARAJANI Tushar J.,
PLONK George,
BETTMANN Michael A.,
MAJEKODUNMI Omotayo,
RUSSELL Gregory B.,
REGAN John D.,
FREEDMAN Barry I.
Publication year - 2008
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1111/j.1542-4758.2008.00245.x
Subject(s) - basilic vein , medicine , arteriovenous fistula , hemodialysis , dialysis , limiting , surgery , mechanical engineering , engineering
The need for reliable, long‐term hemodialysis vascular access remains critical. To determine the long‐term outcomes of transposed basilic vein arteriovenous fistulae (BVT) and their comparability with other vascular accesses, we determined retrospectively the primary and secondary patency rates in 58 BVT and in a total of 58 arteriovenous fistulae (AVF) and arteriovenous grafts (AVG) at a single center. Fifty‐eight BVT were placed in 57 individuals, 69% after prior vascular access failure. Ten BVT failed before initial use and 2 patients expired with functioning accesses before dialysis initiation. In all 58 BVT, 46.8±10.8% functioned at 3 years, with median survival 30.8 months. Limiting analyses to the 46 BVT that were ultimately accessed, 3‐year primary and secondary patency rates were 38.3±7.7% and 56.5±12.6%, respectively. Lower ejection fraction (p=0.054) and greater numbers of prior permanent dialysis catheters (p=0.005) were present in those with failed BVT. Compared with AVF, BVT had similar 3‐year primary and secondary patency rates. The secondary patency rate was significantly better for BVT vs. AVG over the observation period; at 3 years, the rates were 56.5±12.6% vs. 9.1±6.0% (p=0.002), respectively. Basilic vein arteriovenous fistulae are valuable hemodialysis accesses. Although nearly 20% of newly placed BVT will not function before first use, those that are functional have median survivals exceeding 6 years, and 38% will not require intervention within 3 years of initial use.