Ask Dr. Z

I'm looking for guidance on the following procedure since we see it every so often with AV fistula cases. "...Once the vein was completely mobilized, it was it was examined and found to have good flow. The median antecubital nerve was noted to split evenly at the mid to distal aspect of the basilic vein, and, instead of dividing one of the branches, I elected to perform a neuroplasty to split the nerve fibers longitudinally all the way to the axilla. This was done painstakingly with fine scissors to split the perineurium and then the nerve fibers with gentle counter traction. After this was performed, the vein was brought up between the two branches without difficulty."