{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T16:42:34Z","timestamp":1782319354703,"version":"3.54.5"},"reference-count":12,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2024,10,24]],"date-time":"2024-10-24T00:00:00Z","timestamp":1729728000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Vasc Access"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The development of a high flow rate arteriovenous fistula (AVF) can expose the patient to development of heart failure due to increased cardiac preload and pulmonary hypertension.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>AVF flow measurement (Qa) is considered a screening tool for AVF surveillance, aiming to evaluate the access dysfunction and prevent complications, like a non-maturation, suspected stenosis, high-flow AVF, and distal ischemia. In the upper arm AVF, a high Qa may develops, which can expose the patient to the risk of high-output heart failure and ischemia. Although, the exact threshold to define high-flow access is not universally accepted, AVF with a Qa of 1\u20131.5\u2009L\/min or cardio-pulmonary recirculation (Qa\/CO) &gt;20% are considered at risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Subjects:<\/jats:title>\n                    <jats:p>In our work we describe the treatment performed in three patients with high flow AVF treated with DRIL technique with interposition of a Prosthetic Patch, revascularization procedures such as distal inflow revision or RUDI and with innovative technique a \u201ctench snout,\u201d removal the previous anastomosis and reconstruction of the integrity of the radial artery at the terminal in pre and post anastomosis. A PTFE prosthetic segment measuring 5\u2009cm in length and 5\u2009mm in diameter was interposed, terminally anastomosed with the efferent cephalic vein and terminally lateral with the radial artery, reducing the anastomosis to approximately 4\u2009mm.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>All treated patients showed a clear improvement in the clinical picture in particularly heart failure. The calculation of the post-intervention flow rate approximately 1500\u2009mL\/min.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The patient on hemodialysis with arteriovenous fistula must be constantly monitored with clinical examination, monitoring during the hemodialysis session and color Doppler ultrasound of the AVF with calculation of the flow rate. The surgical technique used for flow reduction is chosen on the surgical experience of each operator with the main objective of preserving the autologous AVF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11297298241287946","type":"journal-article","created":{"date-parts":[[2024,10,24]],"date-time":"2024-10-24T11:43:58Z","timestamp":1729770238000},"page":"1748-1753","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["The management of high flow arteriovenous fistula and possible solutions"],"prefix":"10.1177","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-1944-2081","authenticated-orcid":false,"given":"Fabrizio","family":"Cristiano","sequence":"first","affiliation":[{"name":"Department of Neuroscience, Imaging and Clinical Science, Gabriele d\u2019Annunzio University of Chieti and Pescara, Chieti, Italy"},{"name":"ASL 2 Lanciano Vasto Chieti, Nephrology and Dialysis Unit, Contrada Santa Liberata, Ortona, Chieti, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Lodi","sequence":"additional","affiliation":[{"name":"AUSL Pescara, Interventional Nephrology Unit, Via Fonte Romana, Pescara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,10,24]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2019.12.001"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/1129729820969314"},{"key":"e_1_3_2_4_2","first-page":"340","article-title":"High-output cardiac failure related to hemodialysis arteriovenous fistula","volume":"96","author":"Bailey WB","year":"2000","unstructured":"Bailey WB, Talley JD. High-output cardiac failure related to hemodialysis arteriovenous fistula. J Ark Med Soc 2000; 96: 340\u2013341.","journal-title":"J Ark Med Soc"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1053\/ajkd.2002.36329"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/sdi.12366"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nefro.2018.07.001"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfq851"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfm549"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-7125(16)34255-9"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1542-4758.2010.00518.x"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/1129729820968425"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfn261"}],"container-title":["The Journal of Vascular Access"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11297298241287946","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/11297298241287946","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11297298241287946","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T03:25:29Z","timestamp":1777692329000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/11297298241287946"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,24]]},"references-count":12,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1177\/11297298241287946"],"URL":"https:\/\/doi.org\/10.1177\/11297298241287946","relation":{},"ISSN":["1129-7298","1724-6032"],"issn-type":[{"value":"1129-7298","type":"print"},{"value":"1724-6032","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,24]]}}}