Autogenous sapheonus vein graft interposition in arteriovenous fistula formation

Aim: Other techniques are required due to the negative influence of poor superficial venous system calibration (<1.5-2 mm) to the long term patency of the arteriovenous fistula which is documented via preoperative Doppler ultrasound examination. The postoperative outcome of 32 patients were compared prospectively whom autologous saphenous vein bridge graft was interposed between brachial artery/high brachial vein and radial artery/basilic vein. Material and Method: Patients were divided into two groups; patients whom radial artery/basilic vein autologous saphenous vein graft interposition was performed were labelled as Group 1 (17 patients) while patients whom brachial artery/high brachial vein autologous saphenous vein graft was interpositioned were labelled as Group 2 (15 patients). Patients were followed up for 12 months. Graft related complications were recorded. Primary and secondary patency rate were calculated. Results: Graft infection, edema or ischemia of the hand or arm, congestive heart failure and mortality was not observed. There was not a significant difference in puncture site complications between two groups. Primary patency rate was 76.5% (13 of 17) in Group 1 while it was 93.3% (14 of 15) for Group 2 (p=0,185). Secondary patency rate was 82.4% (14 of 17) in Group1 and 100% (15 of 15) for Group 2 (p=0.093). Primary and secondary patency rate were similar between two groups. Discussion: We sought to compare the complication and patency rate of the proximal (brachial artery/high brachial vein) and distal (radial artery/ basilic vein) located bridge graft interpositions and could not found statistical difference between two groups. It is reasonable to keep proximal regions for further interventions, so radial artery/basilic vein bridge graft interposition can be recommended as the initial option according to our findings.