What is transposed Brachiobasilic fistula?
Brachiobasilic transposition fistulae were created for patients in end stage renal failure in whom haemodialysis was being considered. These were either patients in whom previous vascular access had failed, or in whom alternative vascular access such as radiocephalic or brachiocephalic fistula were not possible.
What is fistula transposition?
The arteriovenous fistula transposition is based on a first-stage proximal radial artery to median cubital vein arteriovenous fistula. Transposed brachial veins were elevated and positioned anteriorly to the incision to avoid repeated needle access through the surgical scar (Fig 2).
What causes AV fistula in brain?
Most dural arteriovenous fistulas have no clear origin, although some result from identifiable causes such as traumatic head injury (or traumatic AV fistula), infection, previous brain surgery, venous thrombosis or tumors.
What is a basilic transposition?
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 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].
What is Superficialization of AV fistula?
Superficialization of the AVF is an alternative form of VA that facilitates the construction of an autologous fistula by maximizing the availability of a deeply located vein. Superficialization is also utilized in VA revision to improve the cannulability of an arterialized vein.
What is the most common complication of AV fistulas?
Left untreated, an arteriovenous fistula can cause complications, some of which can be serious. These include: Heart failure. This is the most serious complication of large arteriovenous fistulas.
What is an AV fistula surgery?
An AV fistula is a surgically placed “shunt”; that is, an artery is directly sutured to a vein. An artery is a high-pressure vessel that carries blood away from the heart and delivers nutrients and oxygen to the tissues.
How long does a basilic vein transposition take?
The divided basilic vein in antecubital fossa was brought over fascia through newly created subcutaneous tunnel followed by end-to-side anastomosis. A total of 18 (12 males and 6 females) underwent BVT in the two years period. The mean fistula maturation time was 42 ± 10 days.
How serious is a fistula in the brain?
They rarely cause serious problems with brain development. Dural arteriovenous fistulas occur within the dura, which covers the brain. Sometimes we see symptoms at birth while other times, the condition does not become apparent until later in childhood. A large dural AVF can cause cardiac failure at birth.
How common is a brain fistula?
Dural arteriovenous fistulas (dAVFs) are rare, abnormal connections between arteries and veins in the lining of the brain (the dura). Doctors classify dAVFs as either low-risk or high-risk. Low-risk dAVFs cause drainage into veins of the brain but keep drainage within the dura in the venous sinuses.
How many types of AV fistula are there?
There are 3 basic types of AVF dialysis: Radial Cephalic fistula. Brachial Cephalic. Brachial Basilic Transposition.
How are brachiobasilic fistulas placed in brachiocephalic fistula?
Brachiocephalic fistulas were placed in patients whose preoperative mapping indicated a suitable brachial artery and cephalic vein in the antecubital space ( Figure 1A ). If the cephalic vein was unsuitable, but the basilic vein was suitable, the surgeon created a transposed brachiobasilic fistula.
Is it possible to cannulate the basilic vein in a fistula?
However, the basilic vein is too deep to cannulate and requires transposition to be accessible. Transposition can be performed during fistula creation (single-stage BBTx) or at a second operation after initial fistula creation (two-stage brachiobasilic transposition (BBTx)).
How is the basilic vein converted to the brachial artery?
The basilic vein is gently distended with heparinized saline to eliminate distortion. The brachial artery is then explored at the elbow. The mobilized basilic vein is transposed to the anterior arm inside a subcutaneous pocket by direct dissection (transposition).
Which is better upper arm graft or brachiocephalic fistula?
The two major types of upper arm access placed are the brachiocephalic fistula and the upper arm graft. Once suitability for dialysis has been attained, the brachiocephalic fistula is superior to an upper arm graft, because it requires substantially fewer interventions to maintain long-term patency (2).