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).

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Signs

• Pallor
• Diminished pulses (distal to the fistula)
• Necrosis^[1]
• Decreased wrist-brachial index (ratio of blood pressure measured in the wrist and the blood pressure measured in the upper arm)

Symptoms

• Pain distal to the fistula.

Investigations

• Arteriography^[2]

Treatment

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

See also

• Subclavian steal syndrome
• Terms for anatomical location

References

1. ^ Porcellini M, Selvetella L, De Rosa P, Baldassarre M, Bauleo A, Capasso R. "[Hand ischemia due to "steal syndrome" in vascular access for hemodialysis]". G Chir 18 (1-2): 27-30. PMID 9206477.
2. ^ Asif A, Leon C, Merrill D, Bhimani B, Ellis R, Ladino M, Gadalean F (2006). "Arterial steal syndrome: a modest proposal for an old paradigm.". Am J Kidney Dis 48 (1): 88-97. PMID 16797390.