Basilic Vein Transposition as a Salvage for Failed Vascular Access for Hemodialysis

ABSTRACT

PURPOSE: Maintenance of a functioning vascular access in patients on hemodialysis is very important. To salvage patients with previous access complications, we performed basilic vein transposition in the upper arm or forearm. The purpose of this study was to evaluate the efficacy of basilic vein transposition in cases with hemodialysis graft complications. METHOD: Between March 2004 and August 2007, 11 patients received a basilic vein transposition (BVT) arteriovenous fistula as salvage for failed autogenous or prosthetic vascular access. The medical records and dialysis records were reviewed retrospectively. RESULT: The mean age was 60 (41~71) years and seven patients were male. The most common cause for the renal failure was diabetes in five cases. Upper arm BVT was performed in three patients and forearm BVT in another eight patients. There was no maturation failure. The mean time to maturation time was 45+/-15.5 days. The mean follow-up period was 14.5 months. During this period, two patients developed stenoses that were treated by balloon angioplasty, and two patients died with a patent fistula. The cumulative primary patency rate was 70%. There was no failed fistula during the follow up period. CONCLUSION: Autogenous BVT is a feasible salvage operation for failed vascular access. A BVT should be considered in complicated cases and as primary vascular access.