Document Detail


Prevention better than cure. Avoiding steal syndrome with proximal radial or ulnar arteriovenous fistulae.
MedLine Citation:
PMID:  21462145     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background: Steal syndrome is a significant complication of arteriovenous fistulae (AVF). We wanted to assess an alternative technique to reduce the incidence of steal syndrome and add an extra option for vascular access for long-term hemodialysis patients Methods: All patients who underwent proximal radial or ulnar artery AVF between 2003 and 2007 were evaluated retrospectively. Results: There were 58 patients, 35 men and 23 women, and the median age was 60 years (range 19-85 years). The proximal radial artery was used in 50 (89%) of cases and the ulnar artery in 8. Three fistulae (5%) failed in the first week, 3 others failed later, prior to use?leading to a 90% successful patency rate.?One diabetic patient developed steal syndrome and re-presented to the surgeons at a late stage when they had finger ulceration and it was decided to ligate the fistula in this case. Thus, the overall incidence of steal syndrome was low at 2%. Conclusions: It is suggested that arterio-venous fistulae using proximal radial or ulnar arteries can be performed before brachio-cephalic fistulae since they offer long-term patency and reduced incidence of steal syndrome. Brachio-cephalic AVF can be performed subsequently if necessary.
Authors:
Laura Whittaker; Ali Bakran
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-31
Journal Detail:
Title:  The journal of vascular access     Volume:  -     ISSN:  1724-6032     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-4-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100940729     Medline TA:  J Vasc Access     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Transplant Surgery, Royal Liverpool University Hospital, Liverpool - UK.
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