eISSN: 1897-4252
ISSN: 1731-5530
Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery
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3/2022
vol. 19
 
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abstract:
Review paper

Treatment options for dialysis access steal syndrome

Spyros I. Papadoulas
1
,
Natasa Kouri
1
,
Andreas Tsimpoukis
1
,
Panagiotis Kitrou
2
,
Marios Papasotiriou
3
,
Konstantinos M. Nikolakopoulos
1
,
Georgios-Ioannis Verras
4
,
Ioannis Panagiotopoulos
5
,
Francesk Mulita
4
,
Konstantinos G. Moulakakis
1

  1. Vascular Surgery Department, Patras University Hospital, Patras, Greece
  2. Interventional Radiology Department, Patras University Hospital, Patras, Greece
  3. Department of Nephrology, Patras University Hospital, Patras, Greece
  4. Department of Surgery, General University Hospital of Patras, Patras, Greece
  5. Department of Cardiothoracic Surgery, General University Hospital of Patras, Patras, Greece
Kardiochirurgia i Torakochirurgia Polska 2022; 19 (3): 141-145
DOI: https://doi.org/10.5114/kitp.2022.119762
Online publish date: 2022/10/08
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Vascular access-induced limb ischemia is a known complication of arteriovenous fistulas and grafts. Many techniques have been adopted to prevent steal in high-risk patients and to treat steal in cases of moderate ischemia not controlled with conservative management. A major factor guiding treatment is access flow volume. Management is different when ischemia is combined with the excessive flow in contrast to the combination with normal flow. We describe the most popular techniques encountered in the English literature as a part of a stepwise approach to treating dialysis access steal syndrome. In absence of ischemia, when cardiac issues emerge due to extreme access flow volumes, some of these techniques are also used to decrease flow and protect the heart. Patient’s history, focused clinical examination, color duplex ultrasound examination, pulse oximetry and an angiogram are essential tools to approach this entity.
keywords:

arteriovenous fistula, aneurysm, ischemia, vascular grafting
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