Mobilization and superficialization of basilic vein for brachio basilic fistula

OBJECTIVE: The aim of this study was to report the Armed Forces Hospital, Riyadh, Kingdom of Saudi Arabia experience in 20 patients who underwent brachio basilic fistula. The use of basilic vein for creation of vascular access for hemodialysis has become popular as it has superiority over polytetrafluoroethlene grafts, as it is a native vessel with less complications.

METHODS: From March 2001 to June 2001, 20 patients were selected to have brachio basilic arteriovenous fistula with superficialization, age range between 25-85 years (mean age 55 years). Eight were diabetic and 9 were hypertensive. All patients started the dialysis 6 weeks after the operation. We are planning to extend our study up to 2 years.

RESULTS: Four patients were excluded. Three out of 4 were found to have stenotic short vein and had brachio-axillary Gortex graft and the 4th patient had mobilization of forearm basilic vein looped up and anastomosed to the brachial artery below the elbow. Two out of the remaining 16 fistulas failed, one within 2 weeks and the other after 8 weeks. The remaining 14 are functioning well 6 months after the operation. This is an 85% success rate so far, which is comparable to other studies.

CONCLUSION: Brachio basilic fistula with superficialization is an acceptable access for dialysis with a good success rate and fewer complications compared to brachio axillary Gortex graft.