Irreversible sequela in an arterial venous fistula with steal syndrome: A case study

Raml, Nancy M.

doi:10.1016/j.jvn.2012.02.001

Cited by 3 publications

(4 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The patient received dialysis through his brachiobasilic AVF (Figure 2). 5 The patient stated that he noticed the pulsatile mass one month earlier following one of his weekly dialysis sessions. When he brought it to the attention of his dialysis team, he was instructed to report to the emergency department to be evaluated for a suspected PSA in his VA. A sonogram of the right upper extremity was requested and performed to evaluate the pulsatile mass suspected as being a PSA.…”

Section: Case Studymentioning

confidence: 99%

See 1 more Smart Citation

Sonographer’s Role in the Screening, Diagnosis, and Treatment of Dialysis Fistula Pseudoaneurysms

Gaspard

2020

Journal of Diagnostic Medical Sonography

View full text Add to dashboard Cite

Pseudoaneurysm (PSA) formation, in an arteriovenous fistula (AVF) undergoing hemodialysis, can occur as a result of frequent venipunctures and can lead to a weakened vessel wall. Since many dialysis patients’ lives depend on their weekly hemodialysis sessions, complications that result from dialysis require treatment. A PSA can be a life-threatening complication, especially for these patients. Sonography has been demonstrated to be a useful modality of choice in the screening, diagnosis, and treatment of a PSA. The sonographic appearance of a PSA using gray-scale, color, and spectral Doppler can play a significant role in ruling out other diagnoses. A case study is presented of a dialysis-dependent patient who developed a PSA in his dialysis access site. Sonography played a key role in the diagnosis and follow-up for this specific case. Due to the risks involved with these patients, there is an essential need for sonographers to be competent in performing these examinations. Evaluation of the AVF to check for patency and a thorough assessment of the PSA are required.

show abstract

Section: Case Studymentioning

confidence: 99%

“…Arteriovenous fistula demonstrating an end-to-side connection between the right basilic vein and right brachial artery. 5 …”

Section: Case Studymentioning

confidence: 99%

Sonographer’s Role in the Screening, Diagnosis, and Treatment of Dialysis Fistula Pseudoaneurysms

Gaspard

2020

Journal of Diagnostic Medical Sonography

View full text Add to dashboard Cite

show abstract

“…68,72 There are several possible causes of DASS, including arterial occlusion or insufficiency proximal or distal to the anastomosis, increased flow through the conduit (true steal), or increased flow diverted through collateral vessels. 73,74 One clue to the diagnosis is a diminished or absent radial pulse that should improve with compression of the access site.…”

Section: Steal Syndromementioning

confidence: 99%

Vascular Access Emergencies in the Dialysis Patient

Sweat¹,

Clare²,

Evans³

2017

Emerg Med

View full text Add to dashboard Cite

A ccording to the National Institute of Diabetes and Digestive and Kidney Diseases, approximately 468,000 persons in the United States are on dialysis-a number that continues to grow annually. 1 The 1-year rate for hemorrhagic complications from arteriovenous fistulas (AVFs) is estimated to be 0.4%. 2 One study by Ellingson et al 3 reported 1,654 deaths secondary to fatal vascular access hemorrhage over a 6-year period, accounting for 0.4% of all deaths of hemodialysis (HD) patients in that study. 3 Nonhemorrhagic vascular access-related complications also contribute to the morbidity and mortality associated with AVFs and arteriovenous grafts (AVGs). Venous stenosis resulting in thrombosis has been estimated to occur in 24.7% of AVGs and 9.0% of AVFs, both of which are common causes of access failure. Infection is reported to be the second leading cause of death in dialysis patients, and vascular access-related infection rates are reported to occur in 9.5% of AVGs vs 0.4% to 0.9% of AVFs. 2,4 Pseudoaneurysms and aneurysms range from 30% to 60% for AVFs, 2,5 and contribute to morbidity by limiting available areas to cannulate for dialysis, occasionally requiring surgical revision to restore access function or prevent access rupture. Steal phenomena, including dialysis access-induced steal syndrome (DASS) and ischemic monomelic neuropathy, as well as heart failure secondary to high output are additional contributors to morbidity and mortality. With the growing rate of end-stage renal disease (ESRD) in the United States and the contribution to morbidity and mortality by bleeding and other complications, it is essential to understand how to evaluate and treat these patients in the ED. This article reviews the evaluation and treatment of vascular access emergencies, as well as risk factors that contribute to complications in the ESRD patient population. The authors discuss evaluation and treatment of vascular access-related hemorrhage and nonhemorrhagic vascular access-related complications, along with the risk factors contributing to the increased bleeding in patients with end-stage renal disease.

show abstract

“…15 Steal syndrome is defined as arterial insufficiency distal to the AVF, caused by excessive blood flow through the AV fistula, and the failure of arterial adaption. 16 Aneurysms include true aneurysms with intact layers of vessel walls, as well as pseudoaneurysms with only fibrous tissue made of thrombus. 17 The primary outcome was the primary unassisted patency as well as the cumulative patency of fistulas at 12 months after access surgery.…”

Section: Journal Of Vascular Surgerymentioning

confidence: 99%

A modified nontransposed brachiobasilic arteriovenous fistula versus brachiocephalic arteriovenous fistula for maintenance hemodialysis access

Sun

et al. 2016

Journal of Vascular Surgery

View full text Add to dashboard Cite

show abstract

Irreversible sequela in an arterial venous fistula with steal syndrome: A case study

Cited by 3 publications

References 15 publications

Sonographer’s Role in the Screening, Diagnosis, and Treatment of Dialysis Fistula Pseudoaneurysms

Sonographer’s Role in the Screening, Diagnosis, and Treatment of Dialysis Fistula Pseudoaneurysms

Vascular Access Emergencies in the Dialysis Patient

A modified nontransposed brachiobasilic arteriovenous fistula versus brachiocephalic arteriovenous fistula for maintenance hemodialysis access

Contact Info

Product

Resources

About