Stepwise Incision-Free Ligation for AV Access Flow Reduction: 13-Patient Initial Study

In a retrospective study of 13 hemodialysis patients, the stepwise incision-free lumen-calibrated ligation (SILL) technique reduced mean access flow from 2516 to 921 mL/min (P<0.001) with technical success in all patients and clinical success in 84.6%, no complications.

• Mean access flow decreased from 2516 ± 1118 to 921 ± 227 mL/min (P < 0.001), and venous diameter from 8.20 ± 2.23 to 4.28 ± 0.70 mm.
• Clinical success was achieved in 11 of 13 patients (84.6%), with 4 of 6 patients with steal syndrome experiencing complete symptom relief.
• No complications occurred; all high-flow patients maintained target flow at 1 month.

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