Department of General & Vascular Surgery, Tabriz University of Medical Sciences, Tabriz, Iran; Section of Organ Transplantation, Imam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
Department of General & Vascular Surgery, Tabriz University of Medical Sciences, Tabriz, Iran.
Int J Surg. 2017 Aug;44:76-81. doi: 10.1016/j.ijsu.2017.06.037. Epub 2017 Jun 15.
In patients without or with injured cephalic vein, using the basilic vein for creating arteriovenous fistula (AVF) is the best way for hemodialysis. In order to create AVF, the basilic vein should be superficialized and lateralized. This study sought to examine outcome of relocation of basilic vein in brachiobasilic fistulas in patients with chronic renal failure (CRF).
We evaluated the outcome of creation of brachiobasilic fistula with transposition of basilic vein in 27 patients (14 males and 13 females with mean age of 60.03 ± 8.04 years) with CRF. The success rate and complications were recorded during the follow-up period. The fistula was regarded efficient if cannulation was feasible conveniently and a minimum flow rate of 250 ml/min for 4 h at least for 3 consecutive hemodialysis sessions through both lines was documented 30 days postoperatively.
The mean time gap between previous AVF creation or try and the relocation of basilic vein was 3.55 months. Thirty days postoperatively, 85.2% of the created AVFs were efficiently working. There were postoperative complications in 40.7% of patients including venous hypertension (14.8%), bleeding (7.4%), hematoma (7.4%) and distal paresthesia (11.1%).
Brachiobasilic AVF fistula provides a suitable option for vascular access in cases with failed previous AVF. Relocation of basilic vein for brachiobasilic AVF is technically feasible, safe and with excellent patency in short-term and complication rates are acceptable.
在没有或头静脉受损的患者中，使用贵要静脉来建立动静脉瘘（AVF）是血液透析的最佳方式。为了建立 AVF，贵要静脉应浅化和侧化。本研究旨在检查慢性肾衰竭（CRF）患者中贵要静脉移位在肱-贵要静脉内瘘中的作用。
我们评估了 27 例（14 名男性和 13 名女性，平均年龄 60.03±8.04 岁）CRF 患者通过贵要静脉转位建立肱-贵要静脉内瘘的结果。在随访期间记录成功率和并发症。如果通过两条静脉至少连续 3 次血液透析，每次至少 4 小时，每条线的最小流量为 250ml/min，则认为瘘管有效。
上次 AVF 建立或尝试与贵要静脉移位之间的平均时间间隔为 3.55 个月。术后 30 天，85.2%的新建立的 AVF 能有效工作。40.7%的患者出现术后并发症，包括静脉高压（14.8%）、出血（7.4%）、血肿（7.4%）和远端感觉异常（11.1%）。
肱-贵要静脉 AVF 为先前 AVF 失败的患者提供了一种合适的血管通路选择。贵要静脉移位用于肱-贵要静脉 AVF 在技术上是可行的、安全的，并且在短期内具有极好的通畅率，并发症发生率是可以接受的。
