Enhancing Arteriovenous (AV) Fistula Banding Accuracy with Intraoperative Ultrasound: A Case Report

Division

North Florida

Hospital

Osceola Regional Medical Center

Document Type

Case Report

Publication Date

8-19-2025

Keywords

arteriovenous fistula, AVF, avf banding, brachiocephalic fistula, flow reduction, hemodialysis access, hemodialysis vascular access monitoring, high-output avf, intraoperative duplex ultrasound, real-time flow assessment

Disciplines

Cardiovascular Diseases | Diagnosis | Medicine and Health Sciences | Surgery

Abstract

High-output arteriovenous fistulas (AVFs) pose a risk for volume overload, venous hypertension, and right heart strain in hemodialysis patients. We present a case of a 55-year-old male with a symptomatic high-flow brachiocephalic AVF, successfully managed with intraoperative duplex ultrasound-guided banding. Real-time flow measurements enabled precise titration of constriction, reducing flow from 7,891 to 2,000 mL/minute. Postoperative recovery was uneventful, with symptom resolution and preserved access patency. This case demonstrates the clinical utility of intraoperative duplex ultrasound in enhancing surgical accuracy and optimizing outcomes during AVF revision. Broader adoption may improve safety and standardization in managing high-output dialysis access.

Publisher or Conference

Cureus

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