An immediate postbanding access flow >1 L/min and young age are risk factors for recurrent high flow in a banded brachial artery-based HD access during a 1-year follow-up.

SBL may be effective as single or adjunctive surgical procedure in the treatment of HAIDI in the presence of a Gracz fistula.

Hand ischemia in hemodialysis patients with a brachial artery-based AVF is not caused by a reversed blood flow direction in forearm arteries. However, forearm blood flow is diminished in these patients leading to critically reduced arterial pressures in the hand.

RUDI effectively reduces access flow in a brachial artery-based high-flow HD vascular access. A flow-reducing effect is sustained at 1-year follow-up in most patients. GSV is preferred as an interposition graft compared to a BaV.

RUDI with GSV interposition for HFA offers acceptable patency rates after 3 years although re-interventions are often required. High immediate post-operative flows and young age are associated with recurrent high flow.

Ligation of non-functional venous side branches of an autogenous brachial artery AVF causing hand ischemia leads to prolonged attenuation of hand ischemia whereas access flow volumes are maintained after 1 year of follow up. Side branch ligation must be considered prior to embarking on more invasive surgery for HAIDI.

HFA may influence systemic hemodynamics in some hemodialysis patients. The findings of this study may contribute to a tailored management of a high-flow fistula in this population.

Basilic vein transposition for an unsuitable upper arm needle access segment may attenuate hand ischemia in patients with a brachial AVF previously reporting hemodialysis access-induced distal ischemia.