Background brachiocephalic fistula is a best choice for long term hemodialysis as a vascular access comparing with central venous catheter & arterio venous graft .
Aim: aim of this study is to increase successful rate of brachiocephalic fistula.
Methods: In this study patients divided as controlled group (75 patients) which operated on with classical technique & studded group (225 patients) which operated on with modified technique I e (cut a patch from arterial wall, ligation of distal & deep tributaries , us of heparin , avoid hypotension &keep upper limb extended & supinated.
Results: Overall successful e rate was 90,4% which represent as 84% in controlled group & 92,5% in studded group .
Although DM represent 61% of patients & hypertension represent 56,5% of patients the failure rate was more in patients with HT (72%) & (55,1) in patients with DM.
Conclusion: Modified technique for arteriovenous fistula should be used in all patients with DM,HT & CTD to increase successful rate .
