Brachiobasilic arteriovenous fistulas: A comparative outcome of different operative techniques

Introduction: Brachiobasilic arteriovenous fistula although little complex to create provides a suitable alternative to radiocephalic and brachiocephalic fistula, due to its autogenous nature and protective deep-seated anatomy of basilic vein. The purpose of this study was to evaluate the outcome among various techniques of brachiobasilic fistula (BBF) in terms of patency and complication rates. Methods: We retrospectively identified 50 patients in which BBFs were constructed between January 2015 and January 2018. The basilic vein was transposed in 16 patients and elevated in 34 patients: 14 as a single-stage technique and 20 with a two-stage (delayed elevation) technique. Results: The mean age of patients in this study was 50.8 years, with 72% of them having diabetes mellitus. There was no significant difference in the primary and secondary patencies among various techniques at 6, 12, 18, and 24 months. Neither there was any significant difference found in the complication rates between different techniques used to create BBF. The overall primary patency rates are 78% and 60% and secondary patency rates are 82% and 68% at 1 and 2 years, respectively. Conclusion: BBF can be considered as a true alternative before prosthetic grafts in patients with exhaustive cephalic veins.