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ORIGINAL ARTICLE
Year : 2022  |  Volume : 17  |  Issue : 1  |  Page : 84-88

Vascular access for dialysis - A choice between brachiobasilic versus brachiocephalic arteriovenous fistula


1 Department of General Surgery, JNMC, Sawangi, Wardha, Maharashtra, India
2 Department of Biochemistry, JNMC, Sawangi, Wardha, Maharashtra, India

Correspondence Address:
Dr. Chandrashekhar Mahakalkar
Department of General Surgery, JNMC, Sawangi (Meghe), Wardha, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jdmimsu.jdmimsu_233_22

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Aim: The study aims to compare the vascular access of brachiobasilic arteriovenous fistula (AVF) to that of brachiocephalic AVF for hemodialysis in patients of end-stage renal diseases (ESRDs), in terms of patency, maturation, and the time of cannulation. Objectives: (1) To analyze the patency, maturation, and surgical outcomes of two autogenous upper arms' arteriovenous accesses: brachiobasalic and brachiocephalic AVF. (2) To analyze the factors responsible for patency and maturation of the AVF. (3) To define a criterion for vascular access maturation of the AVF. Methodology: It was a randomized controlled trial done on patients of ESRD on maintenance hemodialysis. Patients were randomized into Group A – brachiobasilic AVF and Group B – brachiocephalic AVF. They were either subjected to brachiocephalic or brachiobasilic AVF according to standard surgical guidelines. Follow-up was taken at day 30, day 90, and 6 months via clinical examination and color Doppler. Results: The patency of brachiobasilic fistula was statistically significant compared to brachiocephalic (patent: −85% vs. 71%, respectively, not patent: −15% vs. 29%, respectively) (P ≤ 0.05) at 6-month follow-up. In fistula used successfully for hemodialysis, significant difference of 73% and 56%, respectively, for brachiobasilic and brachiocephalic was observed. Conclusion: From the above study, it can be concluded that brachiobasilic AVF is superior to brachiocephalic AVF in terms of patency, rate of complications, and surgical outcomes. The factors responsible for the patency and maturation of AVF were identified.


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