Equivalent secondary patency rates of upper extremity Vectra Vascular Access Grafts and transposed brachial-basilic fistulas with aggressive access surveillance and endovascular treatment

Kakkos, Stavros K.; Andrzejewski, Tanja; Haddad, Joseph A.; Haddad, Georges; Reddy, Daniel J.; Nypaver, Timothy J.; Scully, Martha M.; Schmid, Donna L.

doi:10.1016/j.jvs.2007.09.061

Cited by 74 publications

(63 citation statements)

References 28 publications

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“…Several studies have compared various BBAVF with AVG. 3,[11][12][13][14][15][16][17][18][19] In particular, if the patient is already undergoing dialysis via a central venous permacath, one must weigh the risks of prolonged central vein catheterization while awaiting BBAVF maturation with the increased complication rate associated with AVG placement. A previous study showed an increased rate of thrombosis with AV graft compared with BBAVF (relative risk, 2.6; 95% CI, 1.3-5.3).…”

Section: Discussionmentioning

confidence: 99%

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A comparison between one- and two-stage brachiobasilic arteriovenous fistulas

Reynolds

Zayed

Kim

et al. 2011

Journal of Vascular Surgery

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Section: Discussionmentioning

confidence: 99%

“…2,16 AVG and BBAVF were again compared in 2008, showing increased early complications with BBAVF and increased late thrombosis with AVG. 17 Several other technical issues remain unresolved with respect to BBAVF creation. One issue is the optimal timing of superficialization for the two-stage procedure.…”

Section: Discussionmentioning

confidence: 99%

A comparison between one- and two-stage brachiobasilic arteriovenous fistulas

Reynolds

Zayed

Kim

et al. 2011

Journal of Vascular Surgery

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“…11,16,36,37 In a recent study, equivalent secondary patency of BVT and brachial artery-axillary vein polyetherurethaneurea (Vectra, Bard Inc, Tempe, Arizona, USA) grafts were reported. 38 However, to achieve this, significantly more thrombectomy and angioplasty procedures were performed in failing grafts compared with BVT fistulas. With respect to complications, there were significantly more infections requiring removal of the access in the AVG group.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the efficacy of upper arm transposed arteriovenous fistulae and upper arm prosthetic grafts

Woo

Doros

et al. 2009

Journal of Vascular Surgery

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“…Such strategies would, however, need to be further evaluated given the high re-intervention rate required to maintain long-term patency of arteriovenous grafts. 27,28 This study highlights the burden of access related complications and morbidity associated with BBF. The overwhelming majority of patients required an inpatient hospital stay with mean length of hospital admission for BBF creation 2 days compared to 0.5 days for BCF creation.…”

Section: Utilization Of Avfmentioning

confidence: 92%

Brachiobasilic fistulae: an upper limb autologous option for everyone?

et al. 2016

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Purpose Autologous arteriovenous fistulae (AVF) are the vascular access option of choice. However, Brachiobasilic fistula (BBF) are complex procedures with variable outcomes reported in the literature. Our aim was to evaluate outcomes and morbidity associated with BBF in our population. Methods Retrospective analysis of prospectively collected data was undertaken for all 51 BBF created in our institution between January 2010 and March 2013. These were compared to an age and sex-matched group of brachiocephalic fistula (BCF) created over a similar time period. Demographic, operative and outcome data was collected for all patients. The primary end points were primary functional patency, primary-assisted patency and secondary patency at 3, 6 and 12 months. Continuous data was compared using Student's t-test and categorical data using chisquared test (p50.05 is significant). Results Mean patient age was 57 years (range: 21-82). About 45% were male. About 73% of patients were already on hemodialysis (HD) at the time of BBF creation. BBF was the secondary or tertiary access procedure in 60.8% of patients (n ¼ 31). BBF were associated with significant operative burden with 82% of patients requiring a general anaesthetic and median hospital admission of 2 days (range: 1-4). About 75% had a single-stage procedure. About 23.5% (n ¼ 12) required operative revision (superficialization or anastomotic revision for stenosis). Patients with BBF spent an additional 3.45 days/year in hospital as a result of access related complications compared to 0.56 days/year in the BCF group. Primary-assisted patency at 3, 6 and 12 months was better in the BCF group than BBF group (86%, 72% and 48% vs. 71%, 59%, 33%, respectively; p50.01) Primary functional and secondary patency rates at 3, 6 and 12 months were 74%, 58% and 32% and 78%, 63% and 41%, respectively, with an average of 0.33 procedures per AVF to maintain patency (10 fistuloplasties, 4 IR thrombectomy and 3 surgical thrombectomy). About 32% (n ¼ 17) of BBF were never used for HD (seven patients had a patent AVF but did not require HD418 months following creation; nine failed to adequately mature and one patient refused second stage superficialization). Conclusions BBF are associated with a significant initial operative burden and higher complication and poorer patency rates than BCF. About one-third of BBF created in this series were never used. Given the morbidity associated with this procedure, careful consideration should be given to creation of BBF in pre-dialysis patients particularly those in whom the rate of decline in renal function is slow. ARTICLE HISTORY

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Equivalent secondary patency rates of upper extremity Vectra Vascular Access Grafts and transposed brachial-basilic fistulas with aggressive access surveillance and endovascular treatment

Cited by 74 publications

References 28 publications

A comparison between one- and two-stage brachiobasilic arteriovenous fistulas

A comparison between one- and two-stage brachiobasilic arteriovenous fistulas

Comparison of the efficacy of upper arm transposed arteriovenous fistulae and upper arm prosthetic grafts

Brachiobasilic fistulae: an upper limb autologous option for everyone?

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