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The comparison between the present study1Morosetti M. Cipriani S. Dominijanni S. Pisani G. Frattarelli D. Bruno F. Basilic vein transposition versus biosynthetic prosthesis as vascular access for hemodialysis.J Vasc Surg. 2011; 46: 1713-1719Abstract Full Text Full Text PDF Scopus (30) Google Scholar and those reported in the other references2Woo K. Doros G. Ng T. Farber A. Comparison of the efficacy of upper arm transposed arteriovenous fistulae and upper arm prosthetic grafts.J Vasc Surg. 2009; 50: 1405-14511Abstract Full Text Full Text PDF PubMed Scopus (28) Google Scholar, 3Maya I.D. Oser R. Saddekni S. Barker J. Allon M. Vascular access stenosis: comparison of arteriovenous grafts and fistulas.Am J Kidney Dis. 2004; 44: 859-865Abstract Full Text Full Text PDF PubMed Scopus (91) Google Scholar is not correct. In fact, they are retrospective studies, while our study is a randomized one (so the statistical power of our results is stronger despite the minor sample size). Our data are not so far different from those reported in the current literature on this topic. In fact, most of the authors conclude that native vascular accesses show a better primary patency when compared with the prosthetic ones. Moreover, most of the authors consider prosthetic vascular accesses (VA) as a whole as one single group for follow-up, regardless of the different configurations and insertion sites. This is the reason why we gathered prosthetic VA in one batch as well. Basilic vein stenosis and consequent thrombosis, which could develop after a forearm loop arterovenous graft implantation, in most cases makes basilic vein itself fully unusable for transposition, and in any case, it reduces the vessel length (which is itself a limit to transposition because often the vascular segment available for needle puncturing is not so long). The randomized study by Keuter et al4Keuter X.H. De Smet A.A. Kessels A.G. van der Sande F.M. Welten R.J. Tordoir J.H. A randomized multicenter study of the outcome of brachial-basilic arteriovenous fistula and prosthetic brachial-antecubital forearm loop as vascular access for hemodialysis.J Vasc Surg. 2008; 47: 395-401Abstract Full Text Full Text PDF PubMed Scopus (95) Google Scholar compares “autogenous brachial-basilic fistula in the upper arm (BBAVF) or a prosthetic brachial-antecubital forearm loop (PTFE loop),” which are exactly the same VA kinds we considered. This puts in evidence the fact that forearm arterovenous grafts (AVGs) and basilic vein transposition represent two concurring chances for the surgeon in compromised patients. This study concludes that primary patency (PP) is lower for AVGs. In our study, we found that PP was higher for BBAVF; that is exactly the same conclusion. Similarly, results regarding secondary patency are superimposable between the two studies. As regards the impact of a specific kind of VA set-up on subsequent attempts and longevity, keeping in mind the need to spare patient's vessels, we could state that a loop AVG could be implanted anyway after BBAVF thrombosis, using a brachial artery comitans vein. Finally, we fully agree on the possibility of using AVGs as an immediate vascular access in selected patients. In fact, in our conclusions, we state that “given the shorter time to use, in subjects showing compromised clinical conditions and in who a temporary VA is not reliable, AVG could be the first choice.” Regarding “Basilic vein transposition versus biosynthetic prosthesis as vascular access for hemodialysis”Journal of Vascular SurgeryVol. 55Issue 3PreviewMorosetti et al present a study concluding that, when possible, brachiobasilic arteriovenous fistula (BBAVF) should be created in preference to the insertion of an arteriovenous graft (AVG).1 This conclusion concurs with those of other studies.2 Full-Text PDF Open Archive