When creating a cephalic fistula below the elbow fold, the other collaterals must be ligated to perform the anastomosis, from the cephalic vein to the brachial artery. With this technique communication with the basilica can be preserved. A slow maturation of the basilic vein, without causing steal syndrome or significantly interfering with the maturation of the cephalic vein. It also does not cause overload to the right ventricle. If the cephalic vein is not develop or longer viable as vascular access, the mature basilic vein can be used for cephalic repair, usually for proximal
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Vizcarra et al. (2024) studied this question.
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