Brachiobasilic fistula formation - single versus two stage procedure

Eur J Vasc Endovasc Surg. 2013 Jun;45(6):689-92. doi: 10.1016/j.ejvs.2013.03.003. Epub 2013 Mar 27.

Abstract

Background: Brachial basilic (BB) fistulae are a form of vascular access for patients requiring dialysis. They are indicated when the cephalic vein is unsuitable for use. This fistula can be created with either a single stage or a two stage procedure. We aimed to compare the two techniques.

Methods: 73 BB fistulae (29 single and 44 two-stage) were created over a 5-year period (2003-2008). Data including sex, age, dialysis and diabetic status was collected from the case notes. Patency and time to maturity data was collected prospectively on an electronic database within the dialysis unit.

Results: There was no significant difference in functional patency rates between the two methods. A significant difference was identified between patients who had their fistula created prior to starting dialysis compared to those who had their fistula created after starting dialysis, in both initial patency rate (p = 0.017) and long term survival of the fistulae (p = 0.002).

Conclusion: We identified no significant difference of patency between the two methods. This implies that a single stage procedure has benefits, by offering a quicker form of vascular access. Patients who had their fistulae created prior to dialysis had improved patency rates.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Arteriovenous Shunt, Surgical / adverse effects
  • Arteriovenous Shunt, Surgical / methods*
  • Brachial Artery / physiopathology
  • Brachial Artery / surgery*
  • Chi-Square Distribution
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Renal Dialysis*
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome
  • Upper Extremity / blood supply*
  • Vascular Patency
  • Young Adult