It originates on the medial ulnar side of the dorsal venous network of the hand and travels up the base of the forearm, where its course is generally visible through the skin as it travels in the subcutaneous fat and fascia lying superficial to the muscles. Near the region anterior to the cubital fossa , in the bend of the elbow joint, the basilic vein usually connects with the other large superficial vein of the upper extremity, the cephalic vein , via the median cubital vein or median basilic vein. The layout of superficial veins in the forearm is highly variable from person to person, and there is a profuse network of unnamed superficial veins that the basilic vein communicates with. As it ascends the medial side of the biceps in the arm proper between the elbow and shoulder , the basilic vein normally perforates the brachial fascia deep fascia above the medial epicondyle , or even as high as mid-arm.
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Saudi J Kidney Dis Transpl. Basilic vein transposition: A viable alternative for multiple failed arteriovenous fistulas - A single center experience. Primary use of the autogenous arteriovenous access is recommended by the National Kidney Foundation-Dialysis Outcomes Quality Initiative guidelines.
In spite of troublesome comorbidities associated with basilic vein transposition BVT , it is still the most preferred technique when autologous veins are not suitable to construct radio-cephalic fistula RCF and brachiocephalic fistula BCF , arteriovenous fistula AVF. The present study highlights our experience with BVT, with small incision technique, over a period of two years with excellent outcome. This retrospective study included all the patients who underwent BVT at our tertiary care center between March and March The patients with minimum 3 mm basilic vein diameter on Doppler were only included in the study.
A 3-cm horizontal incision was made in antecubital fossa to expose brachial artery and basilic vein. Multiple longitudinal separate second skin incisions cm were made to explore proximal part of basilic vein. Side branches of the vein were isolated and ligated. 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. No bleeding, thrombosis, failure, pseudo aneurysm, or rupture occurred in our patients. The mean follow-up was six months. BVT is an alternative method with excellent initial maturation and functional patency rates requiring less extensive skin incision and surgical dissection.
It is the most durable hemodialysis access procedure for those patients having multiple forearm AVF surgeries.
Small incision basilic vein transposition technique: A good alternative to standard method
Basilic and Femoral Vein Transposition Historical Background In Dagher and colleagues reported a series of 23 upper arm basilic vein transpositions for hemodialysis. The first large series of femoral vein transpositions was published by Gradman and associates in The procedures are analogous but differ in their indications, magnitude, technique, and complications. Basilic Vein Transposition Indications An upper arm basilic vein transposition should be considered whenever a forearm fistula fails or is not feasible.
Basilic and Femoral Vein Transposition