The arteriovenous @entity292 used for vascular access for hemodialysis may contribute to development of @entity712 . Theses @entity1 can present with frequent episodes of @entity712 . Traditional management of high-inflow, a high-cardiac-output @entity292 generally involves either closure or banding. Although high-output state can be controlled, the lifeline of the @entity1 is lost. We describe a series of 17 hemodialysis @entity1 (10 @entity1 and 7 @entity1 ) in whom a novel inflow reduction method was employed. All @entity1 had symptoms of @entity712 (15 brachiocephalic fistulas and two brachioaxillary bypass grafts) and a @entity292 inflow rate above 1600 ml/min. The inflow reduction procedure included ligation of the brachial @entity254 and reconstruction of the @entity292 by using an expanded @entity736 (Gore-Tex Intering) vascular graft in a bypass from the radial artery. The mean (+/- SD) time between @entity292 creation and the inflow reduction procedure was 30 +/- 17 months. The mean access inflow rate decreased significantly after the inflow reduction procedure, from 3135 +/- 692 to 1025 +/- 551 ml/min (p =0.0001). The mean cardiac output rate decreased from 8 +/- 3.1 to 5.6 +/- 1.7 l/min (p = 0.001) with resolution of symptoms. During the follow-up period @entity715 or @entity850 developed in seven @entity1 , three of whom underwent surgical revision. Thirteen of the seventeen accesses (77%) subjected to the inflow reduction procedure remained patent. @entity393 was due to failed fistuloplasty or @entity715 . To our knowledge, this is the first report demonstrating that inflow reduction obtained by distalization of the @entity254 of the access @entity292 is feasible and safe for managing high-inflow, @entity5691 . Longer and larger studies of the inflow reduction procedure and its benefits are needed.

Inflow reduction by distalization of XXXX treats efficiently high-inflow high-cardiac output vascular access for hemodialysis.

@entity1 :: ('9606', 'Species') :: ['women', 'patients', 'patient', 'men'] @entity712 :: ('MESH:D006333', 'Disease') :: ['congestive heart failure', 'congestive hear failure', 'heart failure'] @entity5691 :: ('MESH:D016534', 'Disease') :: ['high-cardiac-output fistulas'] @entity254 :: ('MESH:C563598', 'Disease') :: ['anastomosis'] @entity292 :: ('MESH:D005402', 'Disease') :: ['fistula'] @entity393 :: ('MESH:D034381', 'Disease') :: ['Access loss'] @entity736 :: ('CHEBI:53251', 'Chemical') :: ['polytetrafluoroethylene'] @entity850 :: ('MESH:D003251', 'Disease') :: ['stenosis'] @entity715 :: ('MESH:D013927', 'Disease') :: ['thrombosis']
@entity254 :: (MESH:C563598,Disease) :: ['anastomosis']
