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.