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  • Title: Modified two-stage basilic vein transposition for hemodialysis access.
    Author: Paulson KA, Gordon V, Flynn L, Lorelli D.
    Journal: Am J Surg; 2011 Aug; 202(2):184-7. PubMed ID: 21810498.
    Abstract:
    BACKGROUND: Various techniques for basilic vein transposition have been described, including endovascular, 1-stage, and 2-stage transposition. However, none of these 2-stage techniques include a new arteriovenous anastomosis during the second stage. This study adds to the current literature as well as introducing a new and innovative technique for hemodialysis access. METHODS: Forty-nine basilic vein transpositions were performed. Data were collected retrospectively. Primary and secondary patency was calculated using life table methods. Complications and interventions were recorded. RESULTS: Primary patency was 72% at 1 year, 54% at 2 years, and 54% at 3 years. Secondary patency was 95%, 80% and 65% at 1, 2, and 3 years, respectively. Twenty-nine patients experienced complications related to the fistula, and 15 required intervention to maintain patency. Patency was achieved in 100% of the procedures using percutaneous techniques. CONCLUSIONS: This 2-stage procedure should be strongly considered when planning brachial basilic fistulas for hemodialysis access.
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