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RMJ. 2015; 40(1): 93-95


Modified small incision technique of basilic vein transposition as a means of angioaccess for long-term dialysis: a preliminary report

Muhammed Khan, Kushal Karki, Bux Ali, Zaid Sufi, Muhammed Mubarak, Syed AH Rizvi.




Abstract

Objective: We investigated basilic vein transposition (BVT) for its efficacy and safety and short-term outcome in our setting.
Methodology: All end-stage renal disease (ESRD) patients with no option of wrist and elbow AVF were included. Modified technique was used for creating BVT AVF.
Results: A total of 52 cases were enrolled from January 2012 to January 2013. The mean age was 44.6±15.1 years. Among these, 27(51.9%) were male and 25 (48.1%) female. The average operating time was 3.1±1.3 hours and the average hospital stay was 2.5±0.8 days. All patients were followed for a mean period of 1±0.5 years. At the end of follow-up, the mean primary patency rate was 84.6% (n=44), secondary patency rate was 88.5% (n=46). Primary failure was seen in 2 (3.8%) patients. Failure of maturation of fistula was seen in 3 (5.7%) patients. Maturation rate at 6 week period was 75% (n=39). In postoperative period, the complications were wound infection in 5 (9.6%), hematoma formation in 2 (3.8%), lymphocele in 4 (7.7%), swelling of upper limb in 2 (3.8%) and ischemic pain in 2 (3.8%) patients.
Conclusion: BVT-AVF is a feasible procedure of creating vascular access in patients on whom radio-cephalic and BC-AVF is not possible. With small incision technique, less complications and comparable outcome to conventional technique can be achieved.

Key words: Angioaccess, arteriovenous fistula, dialysis, renal failure, transplantation.






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