Primary and assisted primary patency rates of forearm-loop graft versus radiobasilic with transposition: a retrospective comparative study

Introduction
There were forearm-access surgeries other than a radiocephalic arteriovenous fistula (AVF), but they are not popular in practice. We retrospectively reviewed patients who underwent either forearm-loop graft or a radiobasilic AVF for primary and assisted primary patency rates.
Patients and methods
In total, 43 patients in the period of January 2014 till January 2020, underwent a forearm access other than a radiocephalic AVF, 24 (group A) patients underwent a forearm-loop graft, and 19 (group B) underwent a radiobasilic AVF with basilic transposition in the forearm. Patients were followed up for 24 months, trials of reestablishing patency were recorded to assess primary and primary-assisted patency rates.
Results
There was no statistically significant difference between both groups as regards the demographic data. The mean operative time for group A was 93.92±8.17 min, while in group B, it was 109.84±14 min, which was a statistically significant result. Technical success was achieved in 100% in both groups, while successful dialysis was achieved in 100% of cases in group A, and 89.5% in group B. The mean time for cannulation was shorter in group A being 20.42±2.69 days compared with 43.11±8.45 days in group B (a statistically significant result). Primary patency rates for group A at 3, 6, 12, 18, and 24 months were 95.83, 79.17, 58.33, 41.67, and 33.33%, respectively, while in group B, they were 89.47, 84.21, 73.68, 63.16, and 52.63%, respectively. There was a statistically significant difference between both groups in the primary-assisted patency rate at 24 months (group A was 58.33%, while group B was 89.47%, =0.0391).
Conclusion
Performing a forearm access other than a radiocephalic gives the patient an option before converting to an upper-arm access. Basilic transposition was a better option as regards primary patency and assisted patency rates if it is feasible, if compared with forearm-loop graft. But forearm-loop graft has the advantage of less operative time and earlier cannulation compared with basilic vein transposition.