Brachial-Basilic Autogenous Access

The emphasis on autogenous arteriovenous hemodialysis access has increased the focus on the brachial-basilic autogenous configuration currently recommended by the national guidelines when the cephalic vein is not suitable. The brachial-basilic autogenous access has been extensively studied and compared with both prosthetic (arteriovenous graft [AVG]) and other autogenous accesses. The literature suggests that the brachial-basilic autogenous access is superior to AVGs in terms of patency, reintervention rates, and infectious complications. However, controversy still remains with respect to its role in the treatment algorithm and the technical conduct of the operation. This review will address the ongoing issues and controversies surrounding the brachial-basilic autogenous access and define its role for the hemodialysis access surgeon.