Vascular access outcomes using the transposed basilic vein arteriovenous fistula

被引:49
作者
Segal, JH [1 ]
Kayler, LK
Henke, P
Merion, RM
Leavey, S
Campbell, DA
机构
[1] Univ Michigan, Hlth Syst, Div Nephrol, Taubman Ctr 3914,Dept Internal Med, Ann Arbor, MI 48109 USA
[2] Univ Michigan, Hlth Syst, Dept Surg, Ann Arbor, MI 48109 USA
[3] Vet Adm Ann Arbor Hlth Care Syst, Ann Arbor, MI USA
[4] Thomas Jefferson Univ Hosp, Dept Surg, Philadelphia, PA 19107 USA
关键词
hemodialysis (HD); vascular access; access patency; access complications; arteriovenous fistula (AVF);
D O I
10.1016/S0272-6386(03)00418-9
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Background: Although the transposed basilic vein arteriovenous fistula (TBAVF) is increasingly performed for hemodialysis vascular access in patients lacking adequate superficial veins, little is known about the long-term patency or risk factors for failure. Methods: A retrospective analysis was conducted for 99 patients who had a TBAVF created between April 1997 and October 2001. Primary outcomes were unassisted and assisted patency rates and primary failure rates. Results: This was the first access procedure in 46% of patients, mean age was 55 years, and 46% were men. Unassisted and assisted patency rates were 47% and 64% at 1 year and 41% and 58% at 2 years, respectively. Primary access failure occurred in 23% of cases. Unassisted access patency was significantly worse in patients with a previous access (relative risk [RR], 2.04; confidence interval [CI], 1.09 to 3.85; P = 0.03) or an ipsilateral central venous catheter (RR, 2.92; CI, 1.34 to 6.38; P < 0.01). Primary access failure was affected by older age (RR, 2.0; CI, 1.20 to 3.38; P < 0.01), obesity (RR, 7.1; CI, 1.65 to 30.1; P < 0.05), and a previous vascular access (RR, 6.4; Cl, 1.49 to 27.6; P = 0.01). Steal syndrome requiring intervention occurred in 5% of cases. Conclusion: In summary, the TBAVF provides a viable option for vascular access; however, certain patient characteristics seem to affect long-term patency and should be considered when exploring access options. (C) 2003 by the National Kidney Foundation, Inc.
引用
收藏
页码:151 / 157
页数:7
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