A Modified Technique for Endoscopic Transposition of Upper Arm Basilic Vein in Autologous Arteriovenous Fistula Creation

AbstractA good functioning arteriovenous (AV) fistula or prosthetic graft is indispensable to a hemodialysis-dependent renal failure patient. The superiority of an autologous AV fistula to a prosthetic graft is well known, but the creation of a native AV fistula is usually difficult in older or re-do patients due to the scarcity of usable superficial veins. The transposition of the upper arm basilic vein for brachiobasilic AV fistula creation provides the advantages of an autologous fistula. However, more pain and wound complications from the larger incision have made this procedure less commonly performed. Presently, endoscopic harvesting of the great saphenous vein employed in coronary bypass surgery is feasible and effective in reducing wound complications. We report the modified technique and cases using endoscopic transposition of the upper arm basilic vein for brachiobasilic fistula creation