Outcomes of Single‐Stage Compared to Two‐Stage Basilic Vein Transposition Fistulae

Basilic vein transposition ( BVT ) fistulae are increasing in prevalence in the United States. We examined outcomes of BVT fistulae created in a single stage compared to those created in two stages. Prospective QA databases identified a consecutive cohort of 144 patients with BVT fistulae. Of these, 42% were created in one stage and 58% in two stages. Fistula maturation rates, mean time to fistula use and intensity of percutaneous interventions were compared; patency rates were compared from time of first intervention. Maturation rates (including assisted maturation) were 90% among 1‐stage and 75% among 2‐stage BVT ( p  = 0.02). Mean time to initiation of fistula use was 142 days (1‐stage) and 146 days (2‐stage) ( p  = 0.92). Intensity of percutaneous interventions was 1.84/patient‐year of dialysis ( PYD ) (1‐stage) and 2.15/ PYD (2‐stage) ( p  = 0.57). Secondary patency at 1, 2, 3, and 4 years for 1‐stage BVT was 86%, 75%, 69%, and 57%; secondary patency at 1, 2, 3, and 4 years for 2‐stage BVT was 76%, 71%, 49%, and 25%, respectively ( p  = 0.12). BVT creation in two stages confers only a modest reduction in maturation rates and secondary patency and therefore should be considered over a synthetic graft in patients with basilic veins deemed inadequate for 1‐stage BVT .