Unrecognized Basilic Vein Variation Leading to Complication during Basilic Vein Transposition Arteriovenous Fistula Creation: Case Report and Implications for Access Planning

Introduction: Knowledge about variations of the venous arm anatomy is limited despite its importance for a successful arteriovenous fistula creation. Report: We describe a complication of a Basilic Vein Transposition (BVT) resulting from failure to recognize aberrant anatomy. The brachial-basilic junction was located in an unusual position near the antecubital fossa leading to inadvertent distal brachial vein ligation and transposition of basilic and the proximal and unusually unpaired brachial vein. Discussion: This case highlights the prevalence of anomalies of upper extremity veins and the need for thorough Duplex vein mapping before surgery for the preservation and planning of future access.