Hemodialysis outcome associated with basilic vein transposition or synthetic vascular grafting: a single-center study

Abstract

Background. For hemodialysis, an autogenous radiocephalic or brachiocephalic fistula is the preferred types of vascular access, while basilic vein transposition (BVT) fistula followed by prosthetic grafting is suggested if unsuitable veins are present. The purpose was to compare the outcome of BVT versus synthetic vascular graft used for dialysis in a single centre. Materials and methods. This study includes total of 148 patients that subdivided into two groups: group one (n = 127; 69 male and 58 female patients, mean age 49 years) operated with BVT and group two (n = 21; 15 male and 6 female individuals, mean age 58 years) operated with synthetic vascular graft. Results. Seven patients with hematoma were treated with exploration within 7 days of operation (p = 0.001). Venous hypertension was present in 3 patients of group one and no patient in group two (p = 0.001). In group one, the complication rate was 13.38 %, while in group two, it was 28.57 % with statistically significant difference (p = 0.001). In group one, primary patency rate is 96.85 versus 90.47 % in group two (p = 0.07). The assisted primary in group one was 75 % versus no patient assisted in group two (p = 0.001). Conclusions. This study concludes that use of synthetic graft for dialysis is associated with more complications regarding thrombosis rate, ischemic steal syndrome and infection rate compared to using the basilic vein. In addition to that, the successful rate of embolectomy was low with synthetic graft use.