Nephrol Dial Transplant (2001) 16: 391-394
© 2001 European Renal Association-European Dialysis and Transplant Association
Preliminary Report
Video-assisted basilic vein transposition for haemodialysis vascular access: preliminary experience with a new technique
Department of Surgery, University Hospital Maastricht, Maastricht, The Netherlands
Background. The brachio-basilic vein arteriovenous (AV) fistula is increasingly used as a secondary method for haemodialysis vascular access. The conventional surgical technique of brachio-basilic vein AV fistula creation consists of a long incision with dissection of the basilic vein and transposition of it to a subcutaneous anterior position in the upper arm. The aim of this study was to investigate whether minimal invasive basilic vein dissection with an endoscopic technique is feasible.
Methods. In 12 patients, brachio-basilic vein AV fistulas were created by means of a video-assisted technique with semi-closed dissection and harvesting of the basilic vein with the use of an endoscope and standard endoscopic instruments. All patients underwent pre- and post-operative duplex ultrasound investigation.
Results. In all patients, a successful endoscopic dissection was possible without peri-operative complications. One patient suffered from post-operative thrombotic occlusion, which was successfully treated by thrombectomy. One patient developed a haematoma in the upper arm. No wound complications occurred and all AV fistulas could be used satisfactorily for dialysis treatment.
Conclusions. Video-assisted basilic vein transposition is a feasible minimal invasive technique to create secondary vascular access for haemodialysis.
Keywords: basilic vein transposition; duplex scanning; endoscopy; haemodialysis; vascular access
Correspondence and offprint requests to: Dr J. H. M. Tordoir, Department of Surgery, University Hospital Maastricht, P. Debyelaan 25, Postbox 5800, 6202 AZ Maastricht, The Netherlands.