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The differences in the clinical outcomes between tunnel transposition and elevation for TBBAVF construction have been evaluated in a few retrospective observational studies. Hossny [9] reported no differences in cumulative primary patency and secondary patency between tunnel transposition and one- or two-stage elevation. The author found that the total complication rate was significantly higher in the elevated group. However, most complications involved postoperative arm edema or hematoma formation and could be treated conservatively without fistula failure [9]. In another recent study, Wang et al. [8] also found that for TBBAVF construction, both tunnel transposition and elevation achieved high cumulative patency rates of the whole fistula conduit, including the vasculature from the arteriovenous anastomosis to the right atrium, with an acceptable early postoperative complication profile despite the need for repeated endovascular interventions in a subset of patients. Interestingly, the authors found that compared with tunnel transposition, elevation was associated with better primary patency of the superficialized basilic vein segment and a lower requirement for interventions [8] (Table 2).