The number of patients with chronic kidney disease on regular hemodialysis is continuously increasing and reached 340000 with is as many as one in 359 general population of Japan. Along with the increase of hemodialysis patients, demand of flow volume reduction surgery for complicated hemodialysis access, such as high flow arterio-venous fistula (AVF), edema of AVF limb, ischemia of the AVF limb is also increasing. Banding of the conduit is common procedure of choice for patients require flow volume reduction, but high ratio of thrombosis of AVF, recurrence of high flow is reported. High patency rate after the procedure and stable flow volume reduction over the long term are expected for flow volume reduction surgery. We performed flow volume reduction by using 4 mm diameter prosthetic graft in 7 patients. Average length of the 4 mm graft was 15 cm, mean confirmed patent period is 700.9 days. One patient lost access due to thrombosis of the conduit. Mean flow volume at the referral was 2330 ml/min, and mean flow volume after the procedure was 701 ml/min.

The flow volume reduction surgery using 4 mm prosthetic graft may be regarded to has sufficient flow volume reduction and patency.