Clinical Outcome of Basilic Vein Transposition Arteriovenous Fistula Compared to the Forearm Loop Arteriovenous Graft

Abstract

Purpose: The purposes of this study were to evaluate upper arm basilic vein transposition (BVT) arteriovenous fistula in terms of graft patency and surgical complications and to compare BVT with the forearm loop arteriovenous graft (AVG). Methods: Between March 2003 and December 2008, 23 patients underwent BVT and 30 patients underwent AVG. The patency rates and complications were analyzed. Results: Patients who underwent BVT had more previous history of operations for arteriovenous access (2.5±1.2 in BVT vs. 1.8±1.4 in AVG; P=0.038). A total of 10 cases of complications occurred in patients with BVT and 22 cases in patients with AVG (P=0.047). One-year and 2-year primary patency rates were 55.2%, and 36.3%, respectively, for BVT and 31.3% and 17.9%, respectively, for AVG (P=0.031). One-year and 2-year primary assisted patency rates were 85.2% and 66.7% for BVT, respectively and 67.2% and 43.8 for AVG, respectively (P=0.112). During follow-ups, less rescue procedures were performed in BVT than in AVG patients (P=0.055). One case of thrombolysis, 4 balloon angioplasty, and 1 stent insertion were performed in BVT, whereas 5 cases of thrombectomy, 3 thrombolysis, 4 balloon angioplasty, and 2 interposition grafting were performed in AVG. Conclusion: BVT had higher 1-year and 2-year patency rates and fewer complications compared to AVG. Lower numbers of intervention were required to maintain patency in BVT compared to AVG. BVT is a feasible procedure and can be considered before planning forearm loop AVG, particularly in a rescue vascular access.