Vol. 20 No. 2 (2022)
Case Report

Distal Radial Artery Ligation for Dialysis Access Steal Syndrome

David Fung
University of Alberta
Yaasin Abdulrehman
Department of Surgery, University of Alberta

Published 2022-04-19

Keywords

  • Renal replacement,
  • dialysis,
  • vascular surgery,
  • fistula,
  • steal syndrome,
  • av fistula,
  • ischemia
  • ...More
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How to Cite

1.
Fung D, Abdulrehman Y. Distal Radial Artery Ligation for Dialysis Access Steal Syndrome. McGill J Med [Internet]. 2022 Apr. 19 [cited 2025 Oct. 6];20(2). Available from: https://mjm.mcgill.ca/article/view/898

Abstract

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.

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References

  1. Mousa AY, Dearing, DD, Abu Rahma AF. Radiocephalic Fistula: Review and Update. Annals of Vascular Surgery. 2013;27(3):370-378. doi: 10.1016/j.avsg.2012.07.012.
  2. Chan C, Ochoa CJ, Katz SG. Prognostic Factors for Arteriovenous Fistula Maturation. Ann Vasc Surg. 2018;49:273-276. doi: 10.1016/j.avsg.2018.01.069.
  3. Zamani P, Kaufman J, Kinlay S. Ischemic steal syndrome following arm arteriovenous fistula for hemodialysis. Vascular Medicine. 2009;14(4):371-376. doi: 10.1177/1358863X09102293.
  4. Leake AE, Winger DG, Leers SA, Gupta N, Dillavou ED. Management and outcomes of dialysis access-associated steal syndrome. Journal of Vascular Surgery. 2015;61(3):754-76. doi: 10.1016/j.jvs.2014.10.038
  5. Cordova E, Pettorini L, Scrivano J, Baldinelli M, Punzo G, Menè P, Pirozzi N. Preoperative duplex examination in patients with dialysis access-related hand ischemia: indication for distal radial artery ligation. J Vasc Access. 2015;16(3):255-257. doi: 10.5301/jva.5000341
  6. Miller GA, Khariton K, Kardos SV, Koh E, Goel N, Khariton A. Flow interruption of the distal radial artery: treatment for finger ischemia in a matured radiocephalic AVF. J Vasc Access. 2008;9(1):58-63. doi: 10.1177/112972980800900110