Background Patients who need long-term haemodialysis often require mul
tiple operations to maintain their vascular access. The options for se
condary or tertiary access procedures may become increasingly limited.
Prosthetic conduits are commonly used in difficult cases but are asso
ciated with a high incidence of complications. Methods The brachial ar
tery-transposed basilic vein arteriovenous fistula has been used in pr
eference to a prosthetic graft on 31 occasions. Results There were no
technical failures and 28 of these fistulas matured. No major infectiv
e complications occurred. Conclusion This procedure should be consider
ed before resorting to a prosthetic graft for vascular access.