The staged group had a brachio basilic vein fistula performed first followed by the transposition procedure performed at least 6 weeks later to allow the basilic vein to enlarge. The result, in our population, was the demonstration that the basilic vein was often the only autologous conduit available of adequate size at least 3 mm in diameter that could be used for. Basilic elevation transposition may improve the clinical. Article information, pdf download for quantitative evaluation of the. The cephalic and basilic veins are also located in the forearm and upper arms. To study the place of basilic vein transposition in providing longterm vascular access for patients needing longterm hemodialysis.
Time to hemodialysis median interquartile range of primary and staged procedures was 54 51. Basilic vein article about basilic vein by the free. Each technique may have advantages and disadvantages, and there have been few reports directly. Basilic vein transposition is a feasible and a good method to make avf with autogenous vein. Transposition of the great arteries 0 university of chicago. Basilic vein transposition for creation of arteriovenous fistula subscription required. Transposition of the great arteries tga is associated with several different arrangements of heart anatomy, so is not one condition. A modified technique of basilic vein transposition for. Bulging veins, pain or discomfort, pain or discomfort and. Furthermore, two of the three patients in whom the fistula could not be constructed were found at a later procedure to have an adequate contrallateral basilic vein and underwent autogenous fistula construction of the opposite arm. Once it is felt that further dissection was not possible from this incision, another cm longitudinal incision in the medial aspect of the upper arm and dissection of the basilic vein continued absilic. A modified technique of basilic vein transposition for haemodialysis farid ahmad chaudhary1 and zahid parvez2 abstract objective. Various superficialization techniques have been employed, such as basilic tunnel transposition btt, basilic elevation, and basilic elevation transposition bet. Trial comparing onestage with twostage basilic vein.
Basilic vein definition of basilic vein by medical. Quantitative evaluation of the systemic effects of transposed basilic. Most of the patients these veins are preserved and it has a very good. The basilic vein transposition was the initial angioaccess procedure in only. Transposition of the great arteries tga is the most common cyanotic congenital heart disease chd in newborns, with an incidence of 0.
Though basilic vein transposition is well established in multiple failed fistulaes and obese patients, it requires large incision and morbidities like edema and infection. A forearm cephalic vein avf radial arterycephalic vein, followed by an upper arm. Bulging veins, pain or discomfort upper arm bicep, pain or discomfort upper arm tricep and tenderness to touch. So if you are looking to learn the latest surgical procedures or share your latest surgical knowledge, feel free to browse, learn, share and discuss all for free. Retrospective casecontrolled study, performed in an academic centre. It originates on the medial ulnar side of the dorsal venous network of the hand and travels up the base of the forearm, where its course is generally visible through the skin as it travels in the subcutaneous fat and fascia lying superficial to the muscles.
Basilic vein medical definition merriamwebster medical. Utility of basilic vein transposition for dialysis access. Transposition of basilic vein with minimal incision. However, none of these 2stage techniques include a new. What is critically important is that vein transpositions have expanded the av fistula opportunities and options for patients who would otherwise receive an av graft or catheter if only the more conventional. To avoid such compilations we, at our institution, adopted a small incision technique using two small 34 cm incisions. Ultrasound vascular mapping for preoperative planning of. When simple rcavf or bcavf is not possible due to poor quality veins or previous failures, we. The rhythmic beating of the heart is a ceaseless activity, lasting from.
Open arteriovenous anastomosis by upper arm basilic vein transposition. To compare the outcome of the onestage basilic vein transposition bvt fistula with a modified, twostage technique. Brachial vein transposition arteriovenous fistulas for. Transposed brachiobasilic vein fistula maturation rate after primary procedures 39, 33% was lower compared to maturation rate after staged procedures 77, 100%, p 0. The patient who experienced primary failure is being assessed for surgical suitability for a basilic vein transposition procedure two previous av access failures and a history of central stenosis, and the second patient is being assessed for a transposed basilic vein fistula, pending investigation of hypercoagulability two previous av access failures.
Harvesting the femoral vein may be timeconsuming when there are many tributaries. Basilic vein definition and meaning collins english. Anatomyofthecoronaryarteriesin transposition ofthegreatarteries type a type awasencountered in 11 patients. It represents the final hope for native veins in the creation of an avf, and because the basilic vein usually has a larger diameter than the cephalic vein.
Basilic elevation transposition may improve the clinical outcomes for super. Congenital heart diseases involving only the primary arteries pulmonary artery and aorta belong to a subgroup called transposition of the great arteries. Longterm results of femoral vein transposition for. This specific knowledge of vein placement is only a portion of the advanced education and technical experience necessary for nurses to be adequately equipped. Transposition of the great vessels tgv is a group of congenital heart defects involving an abnormal spatial arrangement of any of the great vessels. Arteriovenous fistula using basilic vein transposition.
Ta arises from the ulnar side of the dorsal venous network of the hand. Longterm outcomes of basilic vein transposition fistula. Basilic vein transposition for creation of arteriovenous. The basilic vein is a large superficial vein of the upper limb that helps drain parts of the hand and forearm. An arteriovenous fistula avf is the preferred vascular access for hemodialysis, offering lower morbidity, mortality, and cost.
Basilic vein transposition bvt was first described in 1976 and has been increasingly accepted as a viable option for secondary or tertiary vascular access. Fistulas created with a transposed basilic vein sutured end to side to the brachial artery have been shown to be the most reliable and dependable secondary vascular access procedure. Pdf clinical outcome of basilic vein transposition. Comparison of transposed brachiobasilic fistulas to upper. Basilic vein arteriovenous fistulas are an important and common option for hemodialysis access and require superficialization before use. Randomized controlled trial comparing primary and staged. Patient with chronic renal failure who has no other veins left for av access is best treated with basilic vein transposition. Though basilic vein transposition is well established in multiple failed fistulaes. What are vein transposition av fistulae and how successful.
Small incision can be applied to basilic vein transposition, which can be less painful and more comfortable to the patients. Transposition of the great arteries tga is a cyanotic congenital heart defect in which the aorta arises from the right ventricle and the pulmonary artery arises. Basilic vein transposition with bbavf creation a v. Basilic vein transposition journal of vascular surgery cases and. Here we describe 2 patients with absence of adequate superficial veins, in whom a transposed brachial vein was used for the creation of an arteriovenous fistula. The brachial artery transposed basilic vein arteriovenous fistulas have been used as a primary, secondary. Relocation of arm vein with connection to arm artery, open procedure.
The staged group had a brachiobasilic vein fistula performed first followed by the transposition procedure performed at least 6 weeks later to allow the basilic vein to enlarge. In order to achieve this, we dissected the cephalic vein in the right arm to its junction with the axillary vein, devalved the cephalic vein and anastomosed it to the contralateral external jugular vein, providing venous drainage to the rul, alleviating symptoms of venous hypertension and preserving function of the brachiobasilic fistula. Hemodialysis adequacy, peritoneal dialysis adequacy and vascular access. 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. Autologous forearm basilic vein looped transposition is an effective surgical procedure for the creation of access for haemodialysis.
In general, the success rates of vein transposition av fistulae are similar to those of the conventional simple direct av fistulae. Surgery theater, with more than 12,000 educational surgery videos, is the worlds first online social medical video sharing for all health care professionals. Article information, pdf download for brachial vein transposition. The common feature is that the connections between the heart and main arteries the aorta carrying blood to the body, and the pulmonary artery carrying blood to.
Webmd symptom checker helps you find the most common medical conditions indicated by the symptoms bulging veins, pain or discomfort upper arm bicep, pain or discomfort upper arm tricep and tenderness to touch including tendinitis, muscle strain, and phlebitis. Backgroundthe transposed basilic vein to brachial artery arteriovenous. It courses through both the forearm and arm, and contributes to the formation of the axillary vein summary. Basilic vein, median definition of basilic vein, median. The basilic vein, along with the cephalic vein, is one of the primary superficial veins that drain the upper limb 1. Brachiobasilic arteriovenous fistula, or basilic vein transposition bvt, is frequently used in hemodialysis access with the benefit that the basilic vein is typically of a larger size than its companion, the cephalic vein.
Ador welding electrodes catalogue pdf a 3cm horizontal incision was made in antecubital fossa to expose brachial artery and basilic vein. In addition to the basilic and cephalic veins, another source of autogenous vein is the brachial vein, a deep vein of the upper arm. Basilic vein, median article about basilic vein, median. Only one upper arm access per patient was included to maintain independence of observations. Various techniques for basilic vein transposition have been described, including endovascular, 1stage, and 2stage transposition. Go to top of page study description study design arms and interventions outcome measures eligibility criteria contacts and locations more information. Transposition of the basilic vein and anastomosis with the brachial vein onestage vs twostage transposition of the basilic vein. Current procedural terminology arteriovenous anastomosis. Accesses were excluded when 1 the cephalic vein was transposed instead of the basilic vein, 2 an axillary artery was used, 3 dialysis was discontinued before access success could be evaluated within 3 months, or 4 patients were lost to followup. Anatomy arteries in transposition ofthe methods for in. Brachiobasilic arteriovenous fistula with transposition of.
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