Arteriovenous Fistula Using Superficialized Basilic Vein in Chronic Hypotensive Hemodialysis Patients

BACKGROUND: Chronic hypotension is common in uremic patients on regular hemodialysis. This subset of patients often requires multiple operations to maintain their vascular access due to frequent thrombosis and occlusion of the arteriovenous fistula. OBJECTIVE: To assess whether surgical intervention with the brachial artery-transposed basilic vein arteriovenous fistula is effective in chronic hypotensive hemodialysis patients. PATIENTS AND METHODS: Fifty-four patients with chronic hypotensive hemodialysis were enrolled in this study. Most of them were referred from local hospitals. They were twenty-three men and thirty-one women. Among them, thirty-six patients were diabetes mellitus. The brachial artery-transposed basilic vein arteriovenous fistula was performed in a period of forty-six months at the teaching Hospital. Primary patency was defined as the length of time from the fistula creation until the development of thrombosis or a complication that required operative revision of the fistula. If the fistula could be salvaged by revision such that blood flow was maintained through the fistula, then the secondary patency was defined. RESULTS: There were no technical failure and none of these patients died due to the surgical operation. The primary patency rate was 89.80% at one year, 73.08% at two years, and 64.71% at three years. The secondary patency rate was 95.92% at one year, 84.62% at two years, and 76.47% at three years. CONCLUSION: Brachial artery-transposed basilic vein arteriovenous fistula may be a good secondary alternative vascular access in the chronic hypotensive hemodialysis patients.

並列關鍵字

arteriovenous fistula ； hemodialysis ； hypotension ； transposed basilica vein

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