Abstract
Objectives: The radial artery-cephalic vein shunt in the forearm is a standard operation for hemodialysis. Because an ulnar artery-basilic vein fistula needs vein translocation from the posterior side, and the artery and vein are small, the second choice of shunt location is usually at the cubital region. After ultrasonography of vessels in the forearm, we constructed ulnar artery-basilic vein shunts using the brachial artery. The clinical results of ulnar artery-basilic vein shunts are described. Methods: Over the previous 9 years, 552 arteriovenous shunts were performed in our hospital in the past, including 44 ulnar artery-basilic vein shunts (8%). The patients were 30 men and 14 women, and their ages ranged from 35 to 87 years (median, 68). The observation periods were from 1 day to 106 months (median, 4 months). The shunt patency rates were calculated using the Kaplan-Meier method. Results: Two patients died from brain infarction and suicide within 1 month after operation. There was no occurrence of vein hypertension or steal syndrome. A further 21 patients developed occlusion or stenosis of the shunts. The primary patency rates were 45.1% at 1 year, and 27.0% at 4 years. Five patients received percutaneous catheter balloon dilatation for occlusion or stenosis of the shunts for a maximum of 7 times in 1 patient. The secondary patency rates were 51.6% at 1 year, and 41.3% at 4 year. Conclusion: For long-term continuation of hemodialysis using arm blood access, the ulnar artery-basilic vein shunt should be considered before establishing a shunt at the cubital region.
