Brachiobasilic arteriovenous fistula with superficialisation and transposition the basilic vein in a one stage surgical technique. Five years of single experience.
Fístulas arteriovenosas nativas humerobasílicas con superficialización y trasposición en un solo acto quirúrgico. Revisión de cinco años de experiencia.
Adult
Aged
Aged, 80 and over
Arteriovenous Shunt, Surgical
/ adverse effects
Brachial Artery
/ surgery
Female
Humans
Kidney Failure, Chronic
/ therapy
Male
Middle Aged
Postoperative Complications
/ epidemiology
Retrospective Studies
Time Factors
Upper Extremity
/ blood supply
Veins
/ surgery
Young Adult
Acceso vascular
Basilic-humeral arteriovenous fistula
Fístula arteriovenosa nativa humerobasílica
Haemodialysis
Hemodiálisis
Single-stage surgical technique
Un solo acto quirúrgico
Vascular access
Journal
Nefrologia
ISSN: 2013-2514
Titre abrégé: Nefrologia (Engl Ed)
Pays: Spain
ID NLM: 101778581
Informations de publication
Date de publication:
Historique:
received:
27
03
2018
revised:
21
08
2018
accepted:
25
11
2018
pubmed:
12
3
2019
medline:
29
5
2020
entrez:
12
3
2019
Statut:
ppublish
Résumé
The basilic vein is a deep vein which usually requires superficialisation and surgical transposition. This is a retrospective study of 119 BBAVF-ST in patients with stage 5D chronic kidney disease who received an implant with a one-stage surgical technique (2011-2015). The percentage of primary (PP), assisted primary (APP) and secondary (SP) permeabilities were assessed, as well as the related complications. We analysed the permeabilities using Kaplan-Meier survival curves and a univariate Log Rank analysis (Mantel-Cox). P values less than or equal to 0.05 were considered as significant. The mean age of the study group was 67.9years, with 63.8% of the subjects being male. A total of 57 complications were detected during the follow-up period: 24 stenosis (42.1%), 11 thrombosis (19.2%), 7 vascular access steal syndromes (12.2%), 7 upper limb oedemas (12.2%), 6 post-puncture haematomas (10.5%) and 2 infections (3.5%). The percentages of PP obtained at 1, 6, 12 and 24months were 92.4%, 79.8%, 66.3% and 52%; APP: 94.1%, 87.3%, 80.4% and 65.6%, and SP: 95%, 89.1%, 84% and 67.5%, respectively. Diabetic patients presented with significantly worse permeabilities than vascular or idiopathic patients: (P=.037, .009 and .019, respectively). According to the results obtained in our study, the one-stage surgical implementation of BBAVF-ST presents high permeability rates and a small number of related complications. Diabetes mellitus is a factor related to a worse surgical prognosis. Some of the biggest advantages are the greater optimisation of health resources and a shorter time in which the central venous catheter needs to remain in the body.
Sections du résumé
BACKGROUND
The basilic vein is a deep vein which usually requires superficialisation and surgical transposition.
MATERIAL AND METHODS
This is a retrospective study of 119 BBAVF-ST in patients with stage 5D chronic kidney disease who received an implant with a one-stage surgical technique (2011-2015). The percentage of primary (PP), assisted primary (APP) and secondary (SP) permeabilities were assessed, as well as the related complications. We analysed the permeabilities using Kaplan-Meier survival curves and a univariate Log Rank analysis (Mantel-Cox). P values less than or equal to 0.05 were considered as significant.
RESULTS
The mean age of the study group was 67.9years, with 63.8% of the subjects being male. A total of 57 complications were detected during the follow-up period: 24 stenosis (42.1%), 11 thrombosis (19.2%), 7 vascular access steal syndromes (12.2%), 7 upper limb oedemas (12.2%), 6 post-puncture haematomas (10.5%) and 2 infections (3.5%). The percentages of PP obtained at 1, 6, 12 and 24months were 92.4%, 79.8%, 66.3% and 52%; APP: 94.1%, 87.3%, 80.4% and 65.6%, and SP: 95%, 89.1%, 84% and 67.5%, respectively. Diabetic patients presented with significantly worse permeabilities than vascular or idiopathic patients: (P=.037, .009 and .019, respectively).
CONCLUSIONS
According to the results obtained in our study, the one-stage surgical implementation of BBAVF-ST presents high permeability rates and a small number of related complications. Diabetes mellitus is a factor related to a worse surgical prognosis. Some of the biggest advantages are the greater optimisation of health resources and a shorter time in which the central venous catheter needs to remain in the body.
Identifiants
pubmed: 30853141
pii: S0211-6995(19)30043-8
doi: 10.1016/j.nefro.2018.11.010
pii:
doi:
Types de publication
Journal Article
Langues
eng
spa
Sous-ensembles de citation
IM
Pagination
388-394Informations de copyright
Copyright © 2019 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.