Clinically significant ischemic steal syndrome and high flow (~>2 L/min) dictate the need to lower flow in an AV access. One treatment for these conditions is a Minimally Invasive Limited Ligation Endoluminal-Assisted Revision (MILLER) banding procedure, pioneered by Dr. Gregg A Miller (American Access Care, Brooklyn, NY). The MILLER procedure uses the ReoCath® Flow Catheter and Endovascular HVT100 Flowmeter to measure flow at the onset of the banding procedure and at its conclusion to confirm adequate flow reduction.
In the past, most fistula banding techniques have relied on measurements of the outside diameter of a fistula to guide reduction in the size of the fistula’s inner diameter. By using an endoluminal balloon as a sizing dowel, the MILLER technique refines the banding procedure so that a fistula’s inner lumen is decreased to a precise dimension. Baseline flow is measured at the outset of the MILLER procedure with a ReoCath® Flow Catheter and HVT100 Endovascular Flowmeter. Then, at the conclusion of the procedure, flow is measured again to ensure that the target flow goal has been met.