Steal in Hemodialysis Patients Depends on Type of Vascular Access

Hoek, F. van; Scheltinga, Marc R.; Kouwenberg, I.; Moret, Karin; Beerenhout, Charles; Tordoir, Jan H.M.

doi:10.1016/j.ejvs.2006.05.018

Cited by 102 publications

(117 citation statements)

References 22 publications

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“…The fi stula fl ow rate, however, does not typically infl uence steal development. Its occurrence rather depends on the peripheral arterial bed and collateral circulation 24,40 .…”

Section: Resultsmentioning

confidence: 99%

“…Other risk factors include the use of brachial artery 30,31 , age over 60 30 , female gender 26, 31 and lupus 26 . In terms of the steal syndrome occurrence, the brachiocephalic fi stula is a risk factor as opposed to the radiocephalic fi stula or to the application of the loop using a vascular prosthesis 24 . In advanced ischemic symptoms with fi nger gangrene, the basic factor is the atherosclerosis 26,27 .…”

Section: Resultsmentioning

confidence: 99%

“…The steal syndrome shows early manifestations in fi stulas performed with a graft as opposed to their later manifestation in autogenous fi stulas in connection with fi stula development 23 . Diabetes mellitus is considered a risk factor for the occurrence of this complication 11,16,[24][25][26][27][28] . However, some authors do not agree 29 .…”

Section: Resultsmentioning

confidence: 99%

“…Eff ort should mainly be made to recognise the early manifestations in order to treat the fi stula in time. A number of methods are recommended: physical examination of the site 24 , digital plethysmography of the arm periphery 24,25,33 , skin temperature monitoring 24 , periphery oxygenation measurement 24 , digital pressure measurements 37 , vessel bundle fl ow rate assessment by colour duplex sonography 33 or arteriography of the entire fi stula bed with or without fi stula compression 25,33 . The fi stula fl ow rate, however, does not typically infl uence steal development.…”

Section: Resultsmentioning

confidence: 99%

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Autogenous Arteriovenous Elbow Fistula for Haemodialysis and Upper Extremity Ischemia

Bachleda¹,

Utíkal²,

Kojecký³

et al. 2007

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Background:The autogenous brachiocefalic or brachiobasilic arteriovenous elbow fi stula is not considered to be only the secondary haemodialysis access. In patients with an unsuitable forearm vessel bundle, it is indicated as primary access and it is the method preferred to the fi stula creation using a vascular prosthesis. Its rather rare complication is the development of upper extremity ischemia.Aim: To summarise current knowledge of this fi stula type and its associated complications Methods: Review of the literature. Results:The creation and maturation of the fi stula and occurrence of the steal syndrome is infl uenced by a number of factors. The analysis and awareness of such factors will provide for creation of a suitable fi stula as well as for timely complication diagnostics and treatment.Conclusions: The autogenous elbow fi stula utilising the brachial artery and the cephalic or basilic vein in the upper extremity represents a high-quality haemodialysis access. Its potential complication is the occurrence of the steal syndrome. Its occurrence and manifestations do not constitute indications for ligation of the access. The gathered information shows that a suitable surgical procedure can help meet the basic rule for haemodialysis access -resolving the ischemia and maintaining the access.

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“…The fi stula fl ow rate, however, does not typically infl uence steal development. Its occurrence rather depends on the peripheral arterial bed and collateral circulation 24,40 .…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Autogenous Arteriovenous Elbow Fistula for Haemodialysis and Upper Extremity Ischemia

Bachleda¹,

Utíkal²,

Kojecký³

et al. 2007

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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“…The 'ischemic score' was 87 (normal < 50) [4]. HAIDI with associated delayed limb growth was diagnosed; this was treated with an uncomplicated access ligation and physical therapy.…”

Section: Case Reportmentioning

confidence: 99%

Retarded hand growth due to a hemodialysis fistula in a young girl

et al. 2009

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Long-term presence of an arteriovenous hemodialysis fistula (AVF) may lead to alterations in hand perfusion. In the case reported here, a 14-year-old girl developed pain associated with hand ischemia 5 years after a successful kidney transplantation. At age 8 years, she required a period of hemodialysis using an autogenous left upper arm AVF. Compared to the healthy right hand, a smaller ischemic left hand was observed in the presence of a patent AVF. Access flow was 1400 ml/min. Seldinger angiography demonstrated a stenotic brachial artery, and duplex measurements indicated a reversed blood flow in the radial artery. AVF ligation abolished the ischemic symptoms. Distal hypotension due to an impaired arterial inflow combined with a low resistance elbow AVF may result in chronic hypoperfusion of acral portions of the extremity and growth retardation. Access ligation is advised in children with an optimal renal transplant function and a patent elbow AVF suffering from lowered distal tissue perfusion.

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Hemodialysis Access Creation and Maintenance

Jennings

Glazer

2012

Vascular Surgery

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Steal in Hemodialysis Patients Depends on Type of Vascular Access

Cited by 102 publications

References 22 publications

Autogenous Arteriovenous Elbow Fistula for Haemodialysis and Upper Extremity Ischemia

Autogenous Arteriovenous Elbow Fistula for Haemodialysis and Upper Extremity Ischemia

Retarded hand growth due to a hemodialysis fistula in a young girl

Hemodialysis Access Creation and Maintenance

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