Long-term results of arteriovenous fistulas using transposed autologous basilic vein

Background: The transposed autologous basilic vein to brachial artery arter iovenous fistula provides vascular access in the absence of adequate superf icial vein. The long-term patency and complication rates of this conduit ar e largely unreported. Patients and methods: Seventy-four brachiobasilic fistulas were performed i n 65 patients. This was a secondary or tertiary access procedure in 84 per cent of patients. Results: Of the 74 fistulas performed, 50 were successfully used for dialys is (68 per cent) and 24 (32 per cent) were never used, including 13 fistula s that failed without being used for dialysis. Of the 74 fistulas, 46 per c ent failed (n = 34), 10 patients died with a functioning fistula (n = 10) a nd five were transplanted. The 30-day secondary patency was 73 per cent at 1 year, 53 per cent at 2 years and 43 per cent at 3 years rate was 96 per c ent. Cumulative secondary patency was 73 per cent at 1 year, 53 per cent at 2 years and 43 per cent at 3 years. Nineteen (26 per cent) fistulas underw ent a further 19 operative procedures. Fifty-one (69 per cent) fistulas dev eloped complications. The most common complications were arm oedema (24 per cent), thrombosis (22 per cent) and bleeding (18 per cent). Conclusion: In high-risk patients the autologous transposed brachiobasilic fistula has equivalent patency and lower complication rates than those repo rted for polytetrafluoroethylene interposition grafts.