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Radiobasilic Versus Brachiobasilic Transposition on the Upper Arm to Avoid Steal Syndrome

Okay Guven Karaca, Ahmet Nihat Basal, Ata Niyazi Ecevit, Mehmet Kalender, Osman Tansel Darcin, Mehmet Ali Sungur

Department of Cardiovascular Surgery, Medical Faculty of Duzce University, Duzce, Turkey

Med Sci Monit 2015; 21:4090-4095

DOI: 10.12659/MSM.896642

Available online:

Published: 2015-12-29

BACKGROUND: Although the proximal radial artery has been reported as an alternative inflow to prevent steal syndrome, brachiobasilic fistula has been reported to be associated with steal syndrome in 10-20% of cases. We aimed to compare proximal radiobasilic arteriovenous fistula (AVF) with brachiobasilic AVFs on the upper arm in terms of steal syndrome and outcomes.
MATERIAL AND METHODS: We used our institutional operative record database to identify 94 patients in whom brachiobasilic AVF (n=40) and radiobasilic AVF (n=54) were placed between January 2009 and December 2013. Postoperative complications such as steal syndrome, venous hypertension, and aneurysm were recorded.
RESULTS: Steal syndrome was determined to occur less frequently in the radiobasilic AVF group (0% vs. 10%, P=0.03). The rates of other complications (bleeding, aneurysm, venous hypertension) between the 2 groups were similar, as were the patency rates.
CONCLUSIONS: Radiobasilic AVF was effective in reducing steal syndrome, with similar early and late outcomes.

Keywords: Adult, Aneurysm, Arm, Arteriovenous Anastomosis, Arteriovenous Fistula - therapy, Arteriovenous Shunt, Surgical, Renal Dialysis, Subclavian Steal Syndrome - prevention & control, Vascular Patency