Steal syndrome following an arteriovenous fistula – case report and treatment option

Cristian Ene Roată, Corneliu Moroșanu, Silviu Tiberiu Makkai-Popa, Adrian Constantin Covic

Abstract


The paper presents the case of a 48 year-old diabetic patient that underwent hemodialysis for a long period of time and presented to our hospital with digital hypoperfusion symptoms following an arteriovenous fistula between the humeral artery and the basilic vein. The anamnesis of the patient reveals prior circulatory problems and in the case of a previous fistula the patient required the amputation of the distal phalanx of the left index finger. The arterial theft syndrome was dealt with in this case by using a simple method based on techniques of flow diminution through the vein, assessing the calibration by means of clinical criteria such as capillary flow, presence of thrill and decrease in pain levels. A 1 year follow-up showed the fistula was still viable and the symptoms diminished to a level that no longer interfered with the lifestyle of the patient.

Keywords


vascular access steal syndrome, preserve vascular access, hypoperfusion ischemic syndrome, arteriovenous fistulas

Full Text:

PDF

References


Tynan-Cuisinier GS, Berman SS. Strategies for predicting and treating access induced ischemic steal syndrome. Eur J Vasc Endovasc Surg 2006; 32(3):309–315.

Tordoir JH, Dammers R, Van der Sande FM. Upper extremity ischemia and hemodialysis vascular access. Eur J Vasc Endovasc Surg 2004; 27:1–5.

Lazarides MK, Staamos DN, Panagopoulos GN, Tzilalis VD, Eleftheriou GJ, Dayantas JN. Indications for surgical treatment of angioaccess-induced arterial ‘steal’. J Am Coll Surg 1998; 187(4):422-426.

Moini M, Rasouli MR, Nouri M. Ligation of the perforating vein: a treatment for steal syndrome in side-to-side elbow arteriovenous fistula. Ann Vasc Surg 2008; 22(2):307.

Zanow J, Kruger U, Scholz H. Proximalization of the arterial inflow: a new technique to treat access-related ischemia. J Vasc Surg 2006; 43:1216-1221.

Walz P, Ladowski JS, Hines A. Distal Revascularization and Interval Ligation (DRIL) Procedure for the Treatment of Ischemic Steal Syndrome after Arm Arteriovenous Fistula. Ann Vasc Surg 2007; 21:468-473.

Minion David J, Moore E, Endean E. Revision Using Distal Inflow: A Novel Approach to Dialysis-associated Steal Syndrome. Ann Vasc Surg 2005; 19(5):625-628.

Gupta N, Yuo TH, Konig G 4th, et al. Treatment strategies of arterial steal after arteriovenous access. J Vasc Surg 2011; 54:162-167.

Yaghoubian A, de Virgilio C. Plication as Primary Treatment of Steal Syndrome in Arteriovenous Fistulas. Ann Vasc Surg 2009; 23:103-107.

Schneider CG, Gawad K, Strate T, et al. Tbanding: A technique for flow reduction of a hyperfunctioning arteriovenous fistula. J Vasc Surg 2006; 43:402-405.

Goel N, Miller GA, Jotwani MC, Licht J, Schur I, Arnold WP. Minimally invasive limited ligation endoluminal- assisted revision (MILLER) for treatment of dialysis access-associated steal syndrome. Kidney Int 2006; 70(4):765-770.




DOI: http://dx.doi.org/10.22551/2015.07.0203.10041

Copyright (c) 2015 Archive of Clinical Cases

Creative Commons License
Archive of Clinical Cases is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

 

ISSN: 2360-6975