Ulnar-basilic fistula: indications, surgical aspects, puncture technique, and results.

Artif Organs

Center of Experimental Surgery and Medicine, Faculty of Medicine, University of Zulia, Maracaibo, Venezuela.

Published: July 2004

Ulnar-basilic fistula (UBF) is an autogenic vascular access option for hemodialysis (HD) first reported in 1967. However, only a few reports dealing with its complications and survival rates have been published in the literature. In the present work the results of 61 UBFs done in 60 adult patients on chronic HD are reported. Forty UBFs were created as primary access and the remaining 21 UBF as secondary access after: (a) thrombosis of an ipsilateral radiocephalic fistula (RCF) in 6 cases, (b) thrombosis of a contralateral RCF in 7 cases, and (c) thrombosis of a brachiocephalic fistula in 2 cases. No episodes of surgical complications, arterial steal, or ulnar nerve damage were observed. Five UBFs thrombosed within the first week after surgery. The 1-, 3-, and 5-year unassisted survival rates were 70.9%, 67.7%, and 57.3%, respectively, which were significantly higher than those reported previously. The inclusion of UBF in routine access plans is recommended.

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http://dx.doi.org/10.1111/j.1525-1594.2004.07370.xDOI Listing

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Article Synopsis
  • The study focuses on ulnar-basilic fistulas (UBFs) for hemodialysis, which are less common than radiocephalic fistulas due to specific anatomical challenges.
  • A retrospective review analyzed 11 UBFs created between 2008 and 2023, finding that while only 3.3% of functional distal AVFs were UBFs, many demonstrated immediate success.
  • The results indicated that UBFs are safe and durable options for hemodialysis despite technical difficulties, particularly for patients with multiple health issues.
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Background: The distal ulnar-basilic arteriovenous fistula (UBAVF) is a rarely used alternative type of vascular access for haemodialysis. The location of the vein on the back aspect of the forearm forces an extremely uncomfortable external rotation of the upper limb during surgery when the patient is in a supine position.

Methods: We present a new approach towards creating UBAVF, which involves placing the patient in the prone position, thus eliminating the aforementioned inconvenience.

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Objective: To evaluate the outcomes of arteriovenous fistulae (AVF), created with VasQ external support device under standard clinical practice across three vascular access clinics.

Methods: This multinational, retrospective study evaluated prospectively collected clinical outcomes of both forearm and upper arm brachiocephalic AVF (BCAVF) created using the VasQ device. Fifty-one AVF patients were pooled from three different vascular access centers in Germany, Italy, and Spain.

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: As per standard guidelines, the recommended order of arteriovenous fistula (AVF) creation for hemodialysis (HD) access is radiocephalic (RC), followed by proximal elbow fistulas and arteriovenous graft. Although ulnar-basilic (UB) fistula has been an alternative to RC-AVF, still this procedure searches clear recommendations. We present here our experience on UB-AVF as the preferred "second procedure" instead of proximal fistula after the RC-AVF.

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Objective: Arteriovenous fistula (AVF) is the preferred access for hemodialysis. Percutaneous transluminal angioplasty (PTA) has become a choice for AVF stenosis, and ultrasound has been used in PTA more frequently.

Methods: This single-center retrospective cohort study analyzed 129 patients who underwent PTA in the First Affiliated Hospital of Chongqing Medical University from January 2016 to December 2016.

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