scholarly journals Distal Radial Artery Ligation for Dialysis Access Steal Syndrome

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
David Fung ◽  
Yaasin Abdulrehman
Keyword(s):  
Radial Artery ◽  
Surgical Techniques ◽  
Limb Ischemia ◽  
Definitive Treatment ◽  
Dialysis Access ◽  
Artery Ligation ◽  
Stage Renal Disease ◽  
End Stage ◽  
Steal Syndrome ◽  
Distal Radial Artery

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.

scholarly journals Distal radial artery ligation for treatment of steal syndrome associated with radiocephalic arteriovenous fistula

2020 ◽  
Vol 2020 (9) ◽  
Author(s):  
Mahmoud Tolba ◽  
Martin Maresch ◽  
Dhafer Kamal
Keyword(s):  
Arteriovenous Fistula ◽  
Radial Artery ◽  
Hemodialysis Patient ◽  
Ulnar Artery ◽  
Complete Relief ◽  
Retrograde Flow ◽  
Palmar Arch ◽  
Artery Ligation ◽  
Steal Syndrome ◽  
Distal Radial Artery

Abstract We present a case of dialysis associated steal syndrome in a hemodialysis patient with left radiocephalic arteriovenous fistula that caused him severe rest pain. Angiography showed retrograde flow from the ulnar artery to the distal radial artery through a hypertrophied palmar arch. The problem was solved by surgical ligation of the distal radial artery leading to complete relief of patient symptoms without any notable complications.

Preoperative Assessment of the Efficacy of Distal Radial Artery Ligation in Treatment of Steal Syndrome Complicating Access for Hemodialysis

1999 ◽  
Vol 13 (6) ◽  
pp. 618-621 ◽  
Author(s):  
Eric Chemla ◽  
Alain Raynaud ◽  
Thierry Carreres ◽  
Marc Sapoval ◽  
Bernard Beyssen ◽  
...  
Keyword(s):  
Radial Artery ◽  
Preoperative Assessment ◽  
Artery Ligation ◽  
Steal Syndrome ◽  
Distal Radial Artery

Preoperative Duplex Examination in Patients with Dialysis Access-related Hand Ischemia: Indication for Distal Radial Artery Ligation

2015 ◽  
Vol 16 (3) ◽  
pp. 255-257 ◽  
Author(s):  
Emanuela Cordova ◽  
Laura Pettorini ◽  
Jacopo Scrivano ◽  
Matteo Baldinelli ◽  
Giorgio Punzo ◽  
...  
Keyword(s):  
Radial Artery ◽  
Dialysis Access ◽  
Artery Ligation ◽  
Hand Ischemia ◽  
Distal Radial Artery

Clinical Considerations in Hemodialysis Access Intervention

2018 ◽  
pp. 594-614
Author(s):  
Eric K. Hoffer
Keyword(s):  
Renal Disease ◽  
Arteriovenous Fistula ◽  
End Stage Renal Disease ◽  
Morbidity And Mortality ◽  
Dialysis Access ◽  
Hemodialysis Access ◽  
National Kidney Foundation ◽  
Clinical Considerations ◽  
Stage Renal Disease ◽  
End Stage

Interventional radiologists developed and refined the endovascular approaches to maintenance of the permanent arteriovenous vascular accesses that are integral to the provision of hemodialysis for patients with end stage renal disease. As methods of percutaneous arteriovenous fistula creation expand the scope of IR, this chapter reviews the clinical indications and preferences pertinent to dialysis access creation with respect to National Kidney Foundation Recommendations. Accesses remain imperfect, plagued by the development of flow-limiting intimal hyperplastic stenoses, and require monitoring and maintenance to minimize complications, morbidity and mortality. The measures of dialysis access function used in the surveillance of vascular accesses that indicate potential stenosis, and the utility of pre-occlusion recanalization of these stenoses are discussed. Complications specific to dialysis access interventions are also addressed.

Current status of heart transplantation

2018 ◽  
pp. 223-240
Author(s):  
Ayyaz Ali ◽  
Robert L. Kormos
Keyword(s):  
Heart Transplantation ◽  
Cardiac Transplantation ◽  
Organ Procurement ◽  
Severe Heart Failure ◽  
Surgical Techniques ◽  
Current Status ◽  
Definitive Treatment ◽  
Term Survival ◽  
The Many ◽  
End Stage

Cardiac transplantation has extended and improved the lives of patients suffering from severe heart failure over many decades. Despite advances in medical therapy, cardiac transplantation remains the definitive treatment for end-stage heart disease. Surgical techniques for organ procurement and implantation, development of appropriate methods for preserving the heart, and understanding the immunological challenges associated with transplantation were among the many areas which required focused investigation. In the current era, heart transplantation is associated with a low operative mortality and excellent long-term survival, however, the major obstacle of shortage of suitable donor organs remains. In the following chapter, recipient selection and management, donor organ procurement and preservation, and surgical techniques of heart transplantation are described in detail.

scholarly journals In-hospital outcomes in patients with critical limb ischemia and end-stage renal disease after revascularization

2016 ◽  
Vol 63 (4) ◽  
pp. 966-973 ◽  
Author(s):  
Alexander Meyer ◽  
Werner Lang ◽  
Matthias Borowski ◽  
Giovanni Torsello ◽  
Theodosios Bisdas ◽  
...  
Keyword(s):  
Renal Disease ◽  
Critical Limb Ischemia ◽  
End Stage Renal Disease ◽  
Limb Ischemia ◽  
Hospital Outcomes ◽  
Stage Renal Disease ◽  
End Stage

Hemodynamic Comparisons Between Different Anastomotic Configurations in Dialysis Access Fistulae

2011 ◽  
Author(s):  
Patrick M. McGah ◽  
Alberto Aliseda ◽  
James J. Riley ◽  
Daniel F. Leotta ◽  
Kirk W. Beach
Keyword(s):  
Peripheral Circulation ◽  
Dialysis Access ◽  
External Influence ◽  
High Failure Rate ◽  
Venous Flow ◽  
Flow Rates ◽  
Capillary Bed ◽  
One Year ◽  
Stage Renal Disease ◽  
End Stage

Arteriovenous fistulae are created surgically to provide an adequate access for dialysis in patients with End-Stage Renal Disease. Producing an autogenous shunt linking an artery and a vein in the peripheral circulation bypasses the high resistance capillary bed in order to provide the necessary flow rates at sites easily accessible for dialysis. In successful fistulae, venous flow rates can easily exceed 1000 mL/min. It has long been recognized that the hemodynamics constitute the primary external influence on the remodeling process [1, 2]; The high flow rate, together with the exposure of the venous tissue to the high arterial pressure, leads to a rapid process of wall remodeling that may end in a mature access or in stenosis and failure. Given the high failure rate of dialysis access (up to 50% require surgical revision within one year [3]), understanding the dynamics of blood flow within the fistula is a necessary step in understanding the remodeling, and ultimately, in improving clinical outcomes.

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