Prone Position Facilitates Creation of Ulnar-Basilic Arteriovenous Fistula

Abstract

Background: The distal ulnar-basilic arteriovenous fistula (UBAVF) is a rarely used alternative type of vascular access for haemodialysis. The location of the vein on the back aspect of the forearm forces an extremely uncomfortable external rotation of the upper limb during surgery when the patient is in a supine position. Methods: We present a new approach towards creating UBAVF, which involves placing the patient in the prone position, thus eliminating the aforementioned inconvenience. The procedure was performed and described in a 46-year-old patient with chronic kidney disease (CKD) due to diabetic nephropathy. In the period from September 2021 to December 2021, we created an additional three UBAVFs with such modifications. Results: All fistulas were patent both immediately after the procedure and 2 weeks after surgery. Conclusions: The prone position may improve the comfort of both the operator and the patient during the procedure. On top of this, it may have a positive impact on the quality of the arteriovenous anastomosis.

Keywords

• ulnar-basilicarteriovenous fistula
• arteriovenous fistula
• haemodialysis
• end-stage renal disease