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Concept: Basilic vein


The care and outcome of patients with end stage renal disease (ESRD) on chronic hemodialysis is directly dependent on their hemodialysis access. A brachiocephalic fistula (BCF) is commonly placed in the elderly and in patients with a failed lower-arm, or radiocephalic, fistula. However, there are numerous complications such that the BCF has an average patency of only 3.6 years. A leading cause of BCF dysfunction and failure is stenosis in the arch of the cephalic vein near its junction with the axillary vein, which is called cephalic arch stenosis (CAS). Using a combined clinical and computational investigation, we seek to improve our understanding of the cause of CAS, and to develop a means of predicting CAS risk in patients with a planned BCF access. This paper details the methodology used to determine the hemodynamic consequences of the post-fistula environment and illustrates detailed results for a representative sample of patient-specific anatomies, including a single, bifurcated, and trifurcated arch. It is found that the high flows present due to fistula creation lead to secondary flows in the arch owing to its curvature with corresponding low wall shear stresses. The abnormally low wall shear stress locations correlate with the development of stenosis in the singular case that is tracked in time for a period of one year.

Concepts: Chronic kidney disease, Dialysis, Force, Shear stress, Artificial kidney, Axillary vein, Cephalic vein, Basilic vein


Basilic vein transposition via single long incision is a renowned technique despite its known wound related complications. Contrary to that, multiple skip incisions technique is thought to have relatively lower wound related complications. But to the best of our knowledge these two techniques have never been formally compared. So we conducted this study to compare both.

Concepts: Cohort study, Cognition, Learning, Arteriovenous fistula, Greatest hits, Superficial vein, Dorsal venous network of hand, Basilic vein


The proximal cephalic vein that enters the axillary vein (cephalic arch) is a common site of stenosis in patients with upper extremity arteriovenous fistulas for hemodialysis (HD). In this study, we present the outcomes of a series of cephalic vein transposition, to determine its utility in the setting of refractory arch stenosis.

Concepts: Arteriovenous fistula, Upper limb, Axillary artery, Axillary vein, Dorsal venous network of hand, Cephalic vein, Basilic vein, Veins of the upper limb


The cephalic vein arises from the radial end of the dorsal venous arch. It turns around the radial border of the forearm and passes proximally along the arm to the shoulder, where it enters the axillary vein by penetrating the clavipectoral triangle. The cephalic vein is prone to vary at the antecubital fossa, where it forms numerous anastomoses. A male cadaver fixated with a 10% formalin solution was dissected during regular anatomy lessons. It was found that the cephalic vein crossed the upper third of the arm between two fasciculi of the deltoid muscle and reached the shoulder, where it passed above the acromion and crossed the posterior border of the clavicle in order to join the external jugular vein. The cephalic vein is one of the most used veins for innumerous activities, such as venipunctures and arteriovenous fistula creation. Furthermore, it is an anatomical landmark known for its consistent anatomy, as it possesses low rates of variability. Despite that, its anatomical variations are clinically and surgically significant and healthcare professionals must be aware of the variations of this vessel. We aim to report a rarely described variation of the cephalic vein and discuss its embryological, phylogenetic and clinical features.

Concepts: Anatomy, Shoulder, Subclavian vein, Deltoid muscle, Clavicle, Dorsal venous network of hand, Cephalic vein, Basilic vein


Basilic vein transposition (BVT) fistulas may be performed as either a one-stage or two-stage operation, although there is debate as to which technique is superior. This study was designed to evaluate the comparative clinical efficacy and cost-effectiveness of one-stage vs two-stage BVT.

Concepts: Clinical trial, Effectiveness, Arteriovenous fistula, Superficial vein, Dorsal venous network of hand, Basilic vein


Transposed basilic vein arteriovenous fistulas suffer from stenosis at their basilic angle of transposition (BAT). This lesion exhibits frequent recurrence after angioplasty. The primary goal of this study was to determine the effect of stent-graft placement on BAT lesion- and access-patency. The secondary goals were to determine the frequency of intervention pre- and post-stent placement and stent-associated stenosis.

Concepts: Stent, Arteriovenous fistula, Fistula, Superficial vein, Axillary vein, Goal, Dorsal venous network of hand, Basilic vein


If a transfemoral approach for catheter ablation procedures of paroxysmal supraventricular tachycardias is impossible, other access sites have to be considered. We present the case of a 78-year-old woman with an inferior vena cava (IVC) filter with symptomatic episodes of an atrioventricular nodal reentrant tachycardia (AVNRT). We used a combined cubital and axillary vein approach. The tachycardia was successfully ablated within the timeframe needed for conventional ablation.

Concepts: Cardiac electrophysiology, Supraventricular tachycardia, Inferior vena cava, Superior vena cava, Tachycardia, AV nodal reentrant tachycardia, Basilic vein


Axillary vein access for pacemaker implantation is uncommon in many centres because of the lack of training in this technique. We assessed whether the introduction of the axillary vein technique was safe and efficient as compared with cephalic vein access, in a centre where no operators had any previous experience in axillary vein puncture.

Concepts: Introduction, Axillary artery, Axillary vein, Dorsal venous network of hand, Cephalic vein, Basilic vein, Veins of the upper limb


Axillary artery injury from humeral neck fracture is an uncommon event. Vascular damage due to these injuries may threaten limb loss. In some cases, the signs of ischemia may not be evident just after the injury and may only appear later on. Therefore, a high index of suspicion is essential. It is important to bear this association in mind, so as to make an early diagnosis and avoid serious complications. We are describing the case of a young patient involved in a motor vehicle crash with an axillary artery trauma due to the surgical neck of humerus fracture. The patient underwent a basilic vein grafting, the postoperative course was good.

Concepts: Blood vessel, Surgery, English-language films, Injury, Damage, Axillary vein, Dorsal venous network of hand, Basilic vein


Existing data on the relationship between venous access and long-term pacemaker lead failure (PLF) are scarce and inconsistent. We aim to study the hypothesis that contrast-guided axillary vein puncture (AP) is better than subclavian puncture (SP) and similar to cephalic vein cutdown (CV) in the incidence of PLF and the success rate of AP is higher than CV.

Concepts: Subclavian vein, Axillary artery, Superficial vein, Axillary vein, Dorsal venous network of hand, Cephalic vein, Basilic vein, Veins of the upper limb