A modified technique of basilic vein transposition for haemodialysis.

OBJECTIVE: To modify the technique of basilic vein transposition for vascular accesss for haemodialysis aiming at better maturation rate, longer survival of fistula and lesser complications. STUDY DESIGN: Case series. PLACE AND DURATION OF STUDY: Shaikh Zayed Hospital and Omer Hospital, Lahore, from February 2008 to July 2011. METHODOLOGY: Patients referred for basilic vein transposition for haemodialysis vascular access were prospectively enrolled. The surgical technique included small tracking incisions, an extra 3 - 4 cm of vein length harvesting to avoid tension in the vein in its new course, an oval arteriotomy and a smooth curved pathway, away from vein harvesting incision to avoid entrapment of vein in the scar. Maturation rate, fistula survival and other complications were noted. RESULTS: There was no immediate failure in 51 patients. The complications during follow-up period were infection and thrombosis, bleeding and non-development of basilic vein in 2 patients each; and false aneurysm formation in one. Four patients died during follow-up period. The maturation time was 4.9 ± 1.1 weeks. The early patency rate was 92.2%, same at 6 months and 90.7% at 12 months. CONCLUSION: Arteriovenous fistula constructed with modified technique of basilic vein transposition is an acceptable and valid option of vascular access for haemodialysis.