Clinical effect of the forearm distal basilic vein transposition vascular fistula constructed with the No-touch vein separation technique

Objective To investigate the clinical effect of the forearm distal basilic vein transposition vascular fistula (BVTVF) constructed with the no-touch vein separation technique. Methods 68 cases of the forearm distal BVTVF constructed in the People’s Hospital of Rizhao Affiliated to Jining Medical College from December 2007 to March 2016 were analyzed retrospectively. Among them, the patients from December 2007 to December 2011 received conventional vein separation technique to separate the basilic vein (36 cases, conventional vein separation technique group), while the patients from January 2012 to March 2016 received No-touch vein separation technique (32 cases, No-touch vein separation technique group). The complications, loss rate and patency rate of the vascular fistula were compared in the 24 months observation period. Results The complication rate in the conventional vein separation technique group was significantly higher than that in the No-touch vein separation technique group during the observation period (vascular stenosis: 33.3% vs 12.5%, P=0.043; pseudoaneurysm: 38.9% vs 15.6%, P=0.033; thrombosis: 27.8% vs 6.3%, P=0.020). The loss rate of the fistula in the conventional vein separation technique group was significantly higher than that in the no-touch vein separation technology group (36.1% vs 12.5%, P=0.025). The postoperative patency rate of the fistula in the conventional vein separation technique group was significantly lower than that of the fistula in the no-touch vein separation technique group (63.9% vs 87.5%, P=0.032). Conclusion Compared with the conventional vein separation technique, applying the No-touch vein separation technique to construct the forearm distal BVTVF could reduce the incidence of complications and prolong the service life of the fistula. Key words: No-touch; Vein separation; Basilic vein; Transposition; Vascular fistula