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Official publication of the Indian Society of Nephrology
 
ORIGINAL ARTICLE
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Brachiocephalic arteriovenous fistula for hemodialysis through the median antecubital vein


1 Department of Cardiothoracic and Vascular Surgery, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidayapeeth University, Puducherry, India
2 Department of Nephrology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidayapeeth University, Puducherry, India

Correspondence Address:
E Elamurugan,
Department of Cardiothoracic and Vascular Surgery, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidayapeeth University, Puducherry - 607 402
India
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Source of Support: None, Conflict of Interest: None

In patients unsuitable for radiocephalic fistula creation, the next option is brachiocephalic fistula. In such patients, we exploited the venous interconnections in the cubital fossa for median cubital vein-Brachiocephalic arteriovenous fistula (AVF) creation. In this article, we describe our experience in the creation of such technical variant of the brachiocephalic fistula AVF, its success and associated complications. A retrospective review of such AVF created between September 2014 and August 2015 was done. The data collected included demographics, co-morbidities, basic disease, operative details, patency, complications, and mortality. A total of 68 vascular access surgeries were done which included 26 (38.2%) brachiocephalic AVF using the median antecubital vein. The mean cephalic vein diameter and mean flow rate were 7.18 mm and 1415 ml/min, respectively 2 months after fistula creation. The primary and secondary failure rates were 3.87% and 7.69% respectively. Complications included aneurysm (7.69%), edema (19.23%), hematoma (11.53%), and wound infection (3.8%). Using reverse flow in the median antecubital vein is a safe and simple way to perform brachiocephalic AVF before brachiobasilic AVF and grafts.


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    -  Elamurugan E
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Indian Journal of Nephrology
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