AVA 3. Efficacy of Staged Brachial Artery-Basilic/Brachial Vein Elevation Arteriovenous Fistula (Axillary Vein Saved)

Abstract

Brachial artery-basilic/brachial vein (Br-Ba/Br) transposition arteriovenous fistula (AVF) has emerged as an autologous AVF, but there have been few reports on the outcomes of Br-Ba/Br elevation AVF instead of conventional transposition. We evaluated efficacy of staged Br-Ba/Br elevation AVF and compared clinical outcomes of Br-Ba and Br-Br elevation AVF. From March 2016 to February 2018, there were 34 patients who underwent two-stage and elevation methods. Medical records of all patients were reviewed retrospectively. Of the 34 patients, 25 received Br-Ba and 9 received Br-Br elevation AVFs. There was no demographic difference between the two groups. In all patients, the median time to cannulation from the first operation was 83 days (interquartile range, 59.5-106.5 days). Maturation failure occurred in one patient (2.9%), which was in Br-Ba elevation AVF. Local access complications occurred in 13 patients (38%), and remote access complications occurred in 5 patients (34%). Cumulative primary patency rates at 6 and 12 months were 83.3% and 73.3%, respectively (Fig). Assisted primary patency rates at 6 and 12 months were 100% and 90.0%, respectively. Secondary patency rates at 6 and 12 months were both 100%. Br-Br elevation AVF showed lower 1-year primary patency than Br-Ba elevation AVF (88% vs 26.3%; P = .004); however, there was no difference in assisted primary patency (93.3% vs 80.0%; P = .36). Staged Br-Ba/Br elevation AVFs are logical modified methods from conventional transposition AVF. Although the 1-year primary patency of Br-Br elevation AVF was lower than that of Br-Ba elevation AVF, both demonstrated excellent 1-year assisted primary patency.