High flow fistulae present a common challenge to vascular access (VA) surgeons and many strategies have been described, each with their benefits and limitations. There are no NK-DOQI guidelines for the management of high flow fistulae or indeed the management of those refractory to more conventional approaches. We discuss a novel technique to inflow reduction in a previously distalized brachiocephalic fistula and recommend the technique of proximal radial artery ligation.
National Kidney Foundation:NKF-DOQI Clinical Practise Guidelines for Vascular Access. Guideline 3- Selection of permant vascular access and order of preference. Available at www.kidney.org/professionals/doqi.
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