ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Ischemic syndrome due to distal hypoperfusion in hemodialysis arteriovenous fistulas
İsmail Oral Hastaoğlu1, Hakan Parlar2, Hamdi Toköz1, Fuat Bilgen1
1Özel Erdem Hastanesi, Kalp ve Damar Cerrahisi Bölümü, İstanbul, Türkiye
2Kars Devlet Hastanesi, Kalp ve Damar Cerrahisi Kliniği, Kars, Türkiye
DOI : 10.5606/tgkdc.dergisi.2013.8328
Background: This study aims to evaluate the reasons for steal syndrome and preventive and therapeutic modalities.

Methods: Thirty-six patients (23 males, 13 females; mean age 58.3 years; 43 to 77 years) who were treated in our cardiovascular outpatient clinic between January 2012 and September 2012 were retrospectively analyzed.

Results: Nineteen of the patients were diabetic (52.7%). Fistulas were located in the antecubital region in 21 patients (58.3%), while others were located in the distal forearm. We performed distal revascularization interval ligation in four patients (11.1%), banding in eight patients (22.2%), plication of anastomosis and dilated venous segment in four patients (11.1%), interposition of 6 mm PTFE graft in five patients (13.8%) and ligation of distal radial artery in eight patients (22.2%). Ligation of radial artery and lateral branches with banding was administered in four patients (11.1%). Three patients (8.3%) underwent revision surgery by using distal inflow. None of the patients had loss of thrill following the procedure. No catheter was required except for one patient. The mean follow-up was 10.9 months (range 1-28 months). The procedure failed in five patients (13.8%). The complaints were completely recovered in 31 patients.

Conclusion: We conclude that the continuity of dialysis can be highly sustained in patients with steal syndrome due to dialysis, maintaining the current arteriovenous fistulas through appropriate revision techniques.

Keywords : Arteriovenous fistula; chronic renal failure; steal syndrome due to dialysis
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