Transposition of the Basilic Vein in the Forearm for the Construction of Haemodialysis Arteriovenous Fistula

Abstract

Twenty-five dialysis patients have been operated 27 times using a modified surgical technique with transposition of the basilic vein for construction of a forearm arteriovenous fistula. The vein is explored at the elbow and dissected free as far distally as possible using small transverse incisions. The vein is cut distally, taken out at the elbow and positioned in a straight, superficial narrow tunnel on the volar side of the forearm for anastomosis to the side of the radial or the ulnar artery. The operation was successful in 19 (76%) cases giving an easily accessible and well-functioning arterialised vein. The surgical technique is simple and is recommended as a primary procedure in patients where the cephalic or other radial or dorsal vein is not available, and as a secondary procedure after failure of a radiocephalic fistula. It is considered of special value for home dialysis patients.