Abstract: 【Abstract】Objective To explore a simple and effective operation to limit the flow of high-flow autogenous arteriovenous fistula (AVF). Methods A total of 12 patients with high-flow AVF treated in the Department of Nephrology, the First Affiliated Hospital of Xiamen University from January 2016 to December 2020 using modified MILLER surgery under ultrasound guidance to limit arterial flow were retrospectively analyzed. These AVFs underwent color Doppler ultrasound examination before operation. During the operation, the core of Terumo 6F vascular sheath was placed on the surface of the proximal artery 2 cm away from the fistula, and the sheath core was looped with a slipknot using a 7-gauge silk thread; there were two ferrules with an average interval of 1cm; color Doppler ultrasound monitors the artery diameter and brachial artery flow at the ferrule, and the tightness of the silk loop was adjusted to make the brachial artery flow within 800-1000 ml/min. Color Doppler ultrasound examination for the AVF was repeated on the day after operation, 3 months after the operation, and half a year after the operation. Results The average diameter of the artery after the operation was significantly reduced compared with that before the operation (t=20.282, P=0.001). The artery diameter at the ferrule was rEexamined after the operation for 3 months and half a year, and the two values had no statistical significance (t=-1.295, -1.342; P=0.209,0.193). The blood flow in the brachial artery after the operation was significantly lower than that before the operation (t=13.923, P=0.001). The postoperative blood flow in the brachial artery was rEexamined after the operation for 3 months and half a year, and the two values had no statistical significance (t=-0.364,-0.806; P=0.719,0.429). Conclusion The modified MILLER operation under ultrasound guidance can accurately adjust the ferrules to effectively limit the flow in highflow AVF. The postoperative blood flow in the AVF was stable. This surgical method is simple, easy to perform, safe, effective, low cost, and worthy of promotion.

Key words: Arteriovenous fistula, Hemodialysis, High flow, Surgery