Brachio-basilic transposition arterio-venous fistula- how much effective for hemodialysis

Abstract

There is a gradual increase in the number of the patients suffering from end stage renal disease and requiring hemodialysis. Hemodialysis can be provided with percutaneous catheters or by creating arterio-venous fistula. In this study we are assessing the effectiveness of the brachio-basilic transposition arterio-venous fistula. This was an anterograde study and we studied 35 patients admitted in nephrology department of Seth Sukhlal Karnani Memorial (SSKM) hospital, Institute of Post-Graduate Medical Education and Research (IPGMER), Kolkata, India. Most of the patients had undergone radio cephalic fistulae in both the arms previously but these fistulae were failed after some time. The other sites for fistula creation were not good, so we created brachio-basilic fistula by basilic vein transposition. We transposed the basilic vein to make it subcutaneous and easily available for cannulation for hemodialysis in all the 35 patients. Brachio-basilic transposition was done in non-dominant arm. These all patients were in age group 45–70 years. Nineteen patients were suffering from diabetes. Twenty-five patients were having whole body oedema so veins were not visible easily. All of these patients doing well and are in follow up. Bracheo-basilic transposition arteriovenous fistula is a good alternative for hemodialysis in patients in whom fistulae were created in other sites but have failed and in whom other good veins are not available. It has good long term patency.