Vena cubiti media for creation of a loop-shaped arteriovenous fistula at the elbow region

Hemodialysis access is one of the major routes, for patients who need long-term hemodialysis. In this report, we tried a new secondary arteriovenous fistula technique. Between January 2000 and June 2003, hemodialysis access was created in more than 650 patients with end-stage renal failure at our institution. In 15 cases a loop-shaped hemodialysis access was created between the brachial artery and vena cubiti media as a second choice. The youngest patient was 12 years old, whereas the oldest was 75. The mean follow-up period (+/-SD) for these patients was 10.4+/-2.53 months. Twelve patients are still using these fistulas successfully for hemodialysis (86.6%), whereas one patient died 7 months after the operation (6.7%). In one patient, the arteriovenous fistula failed 6 months after the operation (6.7%). Thrombosis due to hypotension occured in two cases (13.3%) and this was resolved by simple thrombectomy. One patient had an aneurysm over the vena cubiti media (6.6%). None of the patients had an infection. These results suggest that an end-to-side anastomosis between the brachial artery and, vena cubiti media can be used as a second choice for hemodialysis access in patients with end-stage renal disease.