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Long-term outcomes of transposed basilic vein arteriovenous fistulae.

Authors
  • Moossavi, Shahriar
  • Tuttle, Audrey B
  • Vachharajani, Tushar J
  • Plonk, George
  • Bettmann, Michael A
  • Majekodunmi, Omotayo
  • Russell, Gregory B
  • Regan, John D
  • Freedman, Barry I
Type
Published Article
Journal
Hemodialysis international. International Symposium on Home Hemodialysis
Publication Date
Jan 01, 2008
Volume
12
Issue
1
Pages
80–84
Identifiers
DOI: 10.1111/j.1542-4758.2008.00245.x
PMID: 18271846
Source
Medline
License
Unknown

Abstract

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.

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