Simple and Durable Resolution of Steal Syndrome by Conversion of Brachial Artery Arteriovenous Fistulas to Proximal Radial Artery Inflow

2010 ◽  
Vol 11 (4) ◽  
pp. 352-355 ◽  
Author(s):  
Brett A. Beecher ◽  
Kevin E. Taubman ◽  
William C. Jennings
Choonpa Igaku ◽  
2018 ◽  
Vol 45 (6) ◽  
pp. 605-610
Author(s):  
Masahito MINAMI ◽  
Mayu TUJIMOTO ◽  
Ayako NISHIMOTO ◽  
Mika SAKAGUCHI ◽  
Yasuhiro OONO ◽  
...  

2019 ◽  
Vol 21 (5) ◽  
pp. 799-802 ◽  
Author(s):  
Elisa Maria Schilling ◽  
Malte Weinrich ◽  
Thomas Heller ◽  
Sebastian Koball ◽  
Andreas Neumann

Our patient exhibited a large tumor on his right upper arm where his former dialysis access site had been. X-ray, Doppler ultrasound, and magnetic resonance imaging scan could not fully reveal the nature of that tumor. Eventually, a surgical approach showed a giant aneurysm of the inflowing brachial artery to a partially obliterated arteriovenous fistula. This case highlights the importance of ongoing care for patients with arteriovenous shunts. Even arteriovenous fistulas, that are obliterated or no longer in use, can, especially when immunosuppressant therapy and other vascular risk factors are added to the overall cardiovascular risk, transform and endanger the health of our patients.


2019 ◽  
Vol 54 (1) ◽  
pp. 75-79
Author(s):  
Curtis Woodford ◽  
Elizabeth Tai ◽  
Sebastian Mafeld ◽  
Husain A. Al-Mubarak ◽  
Arash Jaberi ◽  
...  

Brachial artery aneurysms and arteriovenous malformations (AVM) are limb-threatening vascular anomalies. This patient presented with a bilobed brachial artery aneurysm in the antecubital fossa proximally to an AVM arising from the dorsal interosseous and ulnar arteries that had been treated with endovascular embolization, leaving the hand solely supplied by the radial artery. The aneurysm continued to increase in size and imaging revealed concomitant thrombus. A femoral vein interposition graft was used to repair the aneurysm, and postoperatively, the patient retained full left arm function.


2013 ◽  
Vol 4 (4) ◽  
pp. 294 ◽  
Author(s):  
Wen-yuan Li ◽  
Xiao-hai Wang ◽  
Li-chong Lu ◽  
Hao Li

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
David Fung ◽  
Yaasin Abdulrehman

Renal replacement therapy is the definitive treatment for end stage renal disease apart from transplant. Steal syndrome, which can lead to distal limb ischemia, is a rare but serious complication in patients who undergo hemodialysis with an arteriovenous fistula. We present a case of a 48-year-old female with limited options for dialysis access who presented with symptoms of steal syndrome. Given the need to keep her current fistula, we opted to treat her with distal radial artery ligation. This case report summarizes the various surgical techniques available for treating dialysis access-associated steal syndrome and why distal radial artery ligation should be considered a viable management strategy, especially in the context of our patient.


2008 ◽  
Vol 83 (4) ◽  
pp. 307-309 ◽  
Author(s):  
Venkata Ramana Vollala ◽  
Somayaji Nagabhooshana ◽  
Seetharama Manjunatha Bhat

2009 ◽  
Vol 91 (5) ◽  
pp. 394-398 ◽  
Author(s):  
M Field ◽  
J Blackwell ◽  
A Jaipersad ◽  
M Wall ◽  
MA Silva ◽  
...  

INTRODUCTION The global increase of chronic renal failure has resulted in a growing number of patients on haemodialysis using arteriovenous fistulas (AVFs). By virtue of their very function, AVFs at times shunt blood away from regions distally, resulting in an ischaemic steal syndrome. Distal revascularisation with interval ligation (DRIL) has been described as a procedure to treat symptomatic ischaemic steal. We present our experience in the management of this complication. PATIENTS AND METHODS Six patients with severe ischaemic steal were treated using a DRIL procedure between May 2004 and June 2007. There were three males and three females, all with elbow brachiocephalic AVFs. Symptoms ranged from severe rest pain to digital gangrene. Published results from international studies of 135 DRIL procedures were also reviewed. RESULTS Vascular access was maintained along with the elimination of ischaemic symptoms in the six patients using an ipsilateral reversed basilic vein graft. Interval ligation of the distal brachial artery was performed at the same time. All patients showed immediate and sustained clinical improvement of symptoms with a demonstrable increase in digital pulse oximetry. CONCLUSIONS DRIL is a beneficial treatment option that has proven successful at alleviating ischemic steal symptoms and preserving vascular access. This avoids placement of central lines, its associated risks, and the need to create an alternative sited fistula.


2020 ◽  
pp. 112972982098317
Author(s):  
Paschalis Gavriilidis ◽  
Vassilios Papalois

Objectives: International guidelines recommend the use of autogenous vascular access. Where suitable superficial veins are unavailable deeper veins may be used as an option. In most cases, basilic veins are used when cephalic veins are unavailable; arteriovenous fistulas using the brachial vein from the deep venous network are rare. Therefore, the purpose of the present study was to conduct a systematic review of the available literature evaluating the use of the brachial vein in arteriovenous fistulas. Methods: Systematic literature search of electronic databases in accordance with PRISMA was conducted. The primary outcomes of this study were primary and secondary patency rates for brachial vein arteriovenous fistulas; the secondary outcomes were the rates of access thrombosis, steal syndrome, pseudo-aneurysm and infection. Results: The 1-year primary, assisted, and secondary patency was recorded at (24%–77%), (45%–85%) and (45%–96%), respectively. The 2-year primary, assisted and secondary patency rate was recorded at (12%–46%), (19%–75%) and (19%–92%), respectively. However, the consistency regarding the reports and definitions used were highly variable. The incidence rate of infection, thrombosis and steal syndrome was 5% (0%–12%), 15.9% (9.5%–35%) and 3% (2%–6%), respectively. Conclusion: Available studies support the use of brachial veins as a reliable access option in patients with non-accessible superficial veins where an autologous option is required.


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