Pdf transposition of the basilic vein for arteriovenous. Because of its deep position and proximity to the neurovascular bundle, mobilization and anterolateral displacement of the basilic vein is necessary to achieve adequate and safe access. The basilic vein is disconnected and dilated with hepari. Transposed brachiobasilic vein fistula maturation rate after primary procedures 39, 33% was lower compared to maturation rate after staged procedures 77, 100%, p 0. Therefore, the basilic vein transposition bvt as a secondary option is recommended in those patients. This study examined the failure rates and functional patencies of onestage vs twostage brachiobasilic transposition fistulas to compare the two surgical. Dec 06, 2017 patient with chronic renal failure who has no other veins left for av access is best treated with basilic vein transposition. Basilic vein article about basilic vein by the free dictionary. However, in the upper arm, it becomes less visible. Basilic vein transposition with bbavf creation a v. Sep 08, 2017 renal failure patients need a good av access for hemodialysis. The basilic vein, along with the cephalic vein, is one of the primary superficial veins that drain the upper limb 1. Basilic vein transposition used as a tertiary vascular access for hemodialysis.
Basilic vein transposition bvt fulfills the need for a durable conduit with high patency and maturation rates. Ta arises from the ulnar side of the dorsal venous network of the hand. Small incision basilic vein transposition technique. Transposition of the cephalic vein in therapeutic rescue of. The transposition procedure was performed at least 6 weeks later to allow the basilic vein to enlarge, guided by an interval ccdu to confirm this desirable vein diameter.
It originates on the medial 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. The brachial artery transposed basilic vein arteriovenous fistulas have been used as a primary, secondary. Apr 28, 2020 it is a large, noticeable vein found on the upper limb that helps deplete parts of forearm and hand. The surgical procedure entailed transecting the healthy portion of the cephalic vein distal to the stenotic segment in the arch, transposing and anastomosing it to the upper basilic 2. Basilic vein transposition used as a tertiary vascular. Most of the patients these veins are preserved and it has a very good. 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. 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. Upper arm basilic vein transposition for hemodialysis.
Conventional basilic vein transposition bvt conventional bvt figure 1 requires long incision over the medial aspect of the arm. Time to hemodialysis median interquartile range of primary and staged procedures was 54. The aim of this study was to compare the outcomes of three upper arm access types. Basilic vein, median article about basilic vein, median by. The cephalic and basilic veins are also located in the forearm and upper arms. Specifically, it drains blood from parts of the hand and forearm. Transposition of the basilic vein for arteriovenous fistula.
In onestage procedures, the basilic vein is usually mobilised through a singlearm incision along the course of the basilic vein fig. May 02, 2020 journal article utility of basilic vein transposition for dialysis access 2001viewarticle809194 journal article testing for venous disease and evaluation of hemodialysis access. However, for the most part studies comparing bvts to avgs have been retrospective in design and without a set followup protocol. Its part of the systemic circulation and originates from the hand. After dissection, the basilic vein is transposed to a subcutaneous tunnel on the anterior surface of the arm and anastomosed to the brachial artery 10, 11.
Request pdf utility of basilic vein transposition for dialysis access autologous arteriovenous access is the key to longterm success with hemodialysis and is strongly supported by the. Journal article utility of basilic vein transposition for dialysis access 2001viewarticle809194 journal article testing for venous disease and evaluation of hemodialysis access. May 01, 2020 the conventional surgical technique of trans. The conventional surgical technique of basilic vein transposition consists of dissection and mobilizing the basilic vein at the medial side of the upper arm. After dissecting the basilic vein up to axillary vein, it is cut in the cubital fossa and transposed into the subcutaneous tissue by multiple small incisions. The basilic vein brings blood back to the heart from the arm. The basilic vein is mobilized from its usual location and transposed superficially through the deep fascia in the upper arm to create the transposed basilic vein arteriovenous fistula. The option for cephalic vein transposition cvt, described by chen et al. It courses through both the forearm and arm, and contributes to the formation of the axillary vein summary. Basilic vein transposition with bbavf creation a v fistula. Ador welding electrodes catalogue pdf a 3cm horizontal incision was made in antecubital fossa to expose brachial artery and basilic vein.
Utility of basilic vein transposition for dialysis. Basilic vein transposition used as a tertiary vascular access. Basilic vein definition and meaning collins english. Three additional patients underwent exploration of an inadequate basilic vein with subsequent prosthetic grafting. One or twostage basilic vein transposition fistula. Renal failure patients need a good av access for hemodialysis.
Additionally, the upper arm basilic vein is protected from repeated venipuncture given its deep location. 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. The basilic vein transposition was the initial angioaccess procedure in 25% of cases and a secondary access in 75%. The vein travels up the forearm and attaches with the brachial veins to form the vena axillaris axillary vein. Basilic definition and meaning collins english dictionary. Basilic vein definition of basilic vein by medical. Pdf is basilic vein transposition a real alternative to. Basilic vein transpositions bvts are considered to be superior to arteriovenous bypass grafts avgs. Vascular access outcomes using the transposed basilic vein. The basilic vein is well protected from venipuncture through its deep position in the subfascial plane fig.
The average internal diameter of the basilic vein or of the brachiobasilic trunk vein, at the midpoint between the cubitus fold and the inferior. To study the place of basilic vein transposition in providing longterm vascular access for patients needing longterm hemodialysis. No patient died within 30 days of operation, and all operations were performed with the patient receiving general endotracheal anesthetics. Randomized controlled trial comparing primary and staged. Small incision can be applied to basilic vein transposition, which can. Pdf upper arm basilic vein transposition for hemodialysis. This specific knowledge of vein placement is only a portion of the advanced education and technical experience necessary for nurses to be adequately equipped. Transpositioned basilic veins were well matured enough to dialysis. All patients had to have direct arterialization of the basilic vein, therefore, patients with previous ipsilateral wrist fistulas also followed a two.
Background upper arm basilic vein transposition fistula is an excellent tertiary autologous vascular access after radiocephalic and brachiocephalic fistula. Evaluation of the efficacy of the single stage brachio. Basilic vein location, anatomy, function and thrombosis. The basilic vein in the medial aspect of the upper arm is the most common deep vein utilized for arteriovenous fistula creation. Jun 30, 2016 if the cephalic vein or basilic vein in the forearm or cephalic vein in the upper arm doesnt already exist, it is important to select the vein of optimal size after examining the basilic vein in upper arm. Basilic vein medical definition merriamwebster medical. The basilic vein is a common access site for performing digital subtraction venography. Basilic vein transposition william patrick, fracs, sydney, australia james may, ms, fracs, sydney, australia there is general agreement that a radiocephalic ar teriovenous fistula at the wrist is the preferred method of obtaining access to the circulation. Basilic vein definition and meaning collins english dictionary.
The brachiobasilic arteriovenous fistula bbavf can be formed in one or two stages. The basilic vein is one of the most common access sites used for placement of peripherally inserted central catheters primary spontaneous upper extremity deep vein thrombosis view in chinese upper extremity include the cephalic, basilic, median cubital, and accessory cephalic veins the basilic vein is a common access site for. Data were retrospectively revised from all transposition procedures made between september 2005 and november 2012. 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. Transposition of the cephalic vein in therapeutic rescue. One of the main underlying reasons for surgeons performing two staged bbavf is to allow sufficient time for the basilic vein to arterialize and mature prior to transposition. Basilic vein, median article about basilic vein, median.
The basilic vein transposition was the initial angioaccess procedure in only 25% of cases and secondary in 75%. Arteriovenous fistula using basilic vein transposition. Utility of basilic vein transposition for dialysis 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. The rhythmic beating of the heart is a ceaseless activity, lasting from before birth to the end of life.
The basilic vein is a large superficial vein of the upper limb that helps drain parts of the hand and forearm. Therefore, the basilic vein needs to be superficialized and transposed to an anterolateral position. Patient with chronic renal failure who has no other veins left for av access is best treated with basilic vein transposition. Basilic vein article about basilic vein by the free. Although the transposed basilic vein arteriovenous fistula tbavf is increasingly performed for hemodialysis vascular access in patients lacking adequate superficial veins, little is known about the longterm patency or risk factors for failure. This specific knowledge of vein placement is only a portion of the advanced education and technical experience necessary for nurses to be. The average internal diameter of the basilic vein in the fold of the cubitus was 1. Hemodialysis adequacy, peritoneal dialysis adequacy and vascular access. Transposition of basilic vein with minimal incision. Basilic vein transposition is a feasible and a good method to make avf with autogenous vein. The original technique of brachiobasilic av fistula construction is a twostep approach. 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. The authors have been performing preoperative doppler usg for all patients since 2005, and using the vein for bavt that expands more.
When simple rcavf or bcavf is not possible due to poor quality veins or previous failures, we do basilic vein transposition. Leaving the arm, it meets with the subclavian vein. Basilic vein transposition bvt was first described in 1976 and has been increasingly accepted as a viable option for secondary or tertiary vascular access. The upper arm basilic vein is usually inaccessible for dialysis cannulation because of its medial and deep position.
An upper arm vascular access is often placed in patients with a failed forearm fistula or with vessels unsuitable for a forearm fistula. This vein arises from the ulnar position of the dorsal plexus of the hand. If the cephalic vein or basilic vein in the forearm or cephalic vein in the upper arm doesnt already exist, it is important to select the vein of optimal size after examining the basilic vein in upper arm. Deep veins the deep veins of the upper extremity include the paired ulnar, radial, and interosseous veins in the forearm.
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