It remains unclear which vascular access provides better survival in hemodialysis patients with heart failure, superficialization of the brachial artery (SBA), or tunneled central venous catheter (TCVC). We retrospectively followed up 60 hemodialysis patients with heart failure who underwent SBA (n = 36) or TCVC placement (n = 24). During the median 2.2-year follow-up period, 36 patients died. The median survival time was significantly longer for the SBA group than for the TCVC group (5.7 vs 1.7 years; P <.05, log-rank test). A multivariate-adjusted Cox regression analysis showed that SBA was associated with a reduced risk of all-cause death (hazard ratio [HR] 0.30; 95% confidence interval [CI] 0.14-0.65). In the cohort of propensity score-matched 15 pairs, patients with SBA experienced fewer all-cause deaths (HR 0.29; 95% CI 0.10-0.77). Our study suggests that SBA is an alternative option in hemodialysis patients with heart failure.
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