Basilic Vein Transposition

Nephrol Thread December 2002
Submitted by Dr. Joe Miller

I agree with your comments and observations.

I do not "transpose" the basislic vein as has usually been described.  After waiting usually 4-6 weeks, I open up the entire medial forearm and simply move the vein superficially and close the fascia beneath it and the skin above it.  The vein usually lies within 2-3 mm below the scar but can be accessed with the cannulas from aside the scar angling inward to the fistula.

This way, I do not have to redo any anastomosis.  The outflow is simply the native basilic vein path.  The fistula is straight anywhere up to the axilla.  The skin is usually anesthetic from the scar.

Below is a photo of a basilic vein I "transposed" this week. The fascia and muscle are closed but the skin is still open. The wound is <10mm deep.  The measuring stick is 15cm long for reference.

(To View Original Image Click on Thumbnail)