Native forearm fistulas utilizing the basilic vein: an underused type of vascular access.

BACKGROUND: Arteriovenous fistulas (AVFs) are the solution of choice among diverse types of vascular access. The forearm basilic vein is rarely used for creating autogenous vascular access. Its use presents a valuable option when autogenous wrist radial-cephalic direct access cannot be created due to the destruction of forearm veins. Results obtained with autogenous wrist ulnar-basilic direct access and autogenous wrist radial-basilic transposition are presented below.

METHODS: In the decade 1993-2003, native fistulas utilizing the forearm basilic vein were performed in 27 patients (14 women, 13 men). The basilic vein was anastomosed to the ulnar artery or was transposed and anastomosed to the radial artery.

RESULTS: AVF creation was successful in 22 patients (81.5%). The primary patency rate was 70.4% after 1 year, 61.6% after 2 years and 48.4% after 3 years.

CONCLUSIONS: AVFs utilizing the forearm basilic vein can be considered for primary or secondary vascular access because of the acceptable survival rate and low incidence of hand ischemia. Transposition of the basilic vein is a valuable option in the reconstruction of a thrombosed or stenosed radial-cephalic fistula.