One-stage versus two-stage brachiobasilic arteriovenous fistula with superficialization of the basilic vein regarding patency and failure rates | ||
| The Egyptian Journal of Surgery | ||
| Article 6, Volume 41, Issue 1, January 2022 PDF (478.77 K) | ||
| DOI: 10.4103/ejs.ejs_270_21 | ||
| Authors | ||
| Mostafa U.M. Lebda; Yasser M.Abd Alsamea; Abdulrahman M.A. Salem | ||
| Abstract | ||
| Background Safe, reliable, and durable vascular access is essential for successful hemodialysis. Native arteriovenous fistulae have the best long-term patency rates compared with other methods, for example, synthetic grafts and double-lumen catheters. Autogenous arteriovenous fistulae also have the lowest cost and lowest infection rate. If the patient does not have a suitable cephalic vein at the wrist for a Brescia–Cimino–Appel native arteriovenous fistula or at the upper arm for a brachiocephalic arteriovenous fistula, brachiobasilic arteriovenous fistulas (BBAVF) transposition is considered. Currently, there are two usual methods of BBAVF creation: a one-stage or a two-stage operation. Objectives The aim of this study is to compare between one-stage and the two-stage techniques in the formation of BBAVF regarding primary patency, secondary patency, and failure rates. Patients and methods A total of 56 patients with end-stage renal disease were enrolled in the study. The study is a prospective randomized interventional analytical clinical trial conducted in El-Sahel Teaching and Ain Shams hospitals. All patients were evaluated for full history, upper extremity examination, and measurements of basilic vein and brachial artery diameters using duplex. A total of 56 patients were included from the Vascular Surgery Department of Ain Shams University and El-Sahel Teaching hospitals (and other authorized hospitals under the supervision of thesis supervisors). Results On following up the patients over a period of 6 months, there was a primary patency rate of 82.1% for all of the patients who underwent one-stage BBAVF, compared with a 96.4% primary patency rate for those who underwent two-stage BBAVF. There was no statistically significant difference between both groups regarding the primary patency rate over a period of 6 months (=0.084). There was a 92.9% secondary patency rate for all of the cases in both groups (=1.000). None of the cases were considered to have primary failure. Conclusion There was no statistically significant difference between one-stage and two-stage techniques of BBAVF creation, with comparable complication rates between both groups. | ||
| Keywords | ||
| brachiobasilic arteriovenous fistula; End-stage renal disease; one-stage technique; two-stage technique | ||
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