Vascular access steal syndrome

Vascular access steal syndrome

In nephrology, vascular access steal syndrome, also known less precisely as steal syndrome, refers to vascular insufficiency resulting from a poorly constructed arteriovenous fistula (Cimino fistula, or synthetic vascular graft-AV fistula).

igns

*Pallor
*Diminished pulses (distal to the fistula)
*Necrosis [cite journal | author = Porcellini M, Selvetella L, De Rosa P, Baldassarre M, Bauleo A, Capasso R | title = [Hand ischemia due to "steal syndrome" in vascular access for hemodialysis] | journal = G Chir | volume = 18 | issue = 1-2 | pages = 27–30 | year = | pmid = 9206477]
*Decreased wrist-brachial index (ratio of blood pressure measured in the wrist and the blood pressure measured in the upper arm)

ymptoms

*Pain distal to the fistula.

Investigations

*Arteriography [cite journal | author = Asif A, Leon C, Merrill D, Bhimani B, Ellis R, Ladino M, Gadalean F | title = Arterial steal syndrome: a modest proposal for an old paradigm. | journal = Am J Kidney Dis | volume = 48 | issue = 1 | pages = 88–97 | year = 2006 | pmid = 16797390 | doi = 10.1053/j.ajkd.2006.03.077]

Treatment

*Access ligation/vein banding (banding of the fistula or a vessel distal to the fistula to restrict flow through the fistula)

ee also

*Subclavian steal syndrome
*Terms for anatomical location

References


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