Prevention better than cure. Avoiding steal syndrome with proximal radial or ulnar arteriovenous fistulae.
J Vasc Access
; 12(4): 318-20, 2011.
Article
de En
| MEDLINE
| ID: mdl-21462145
ABSTRACT
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 patientsMETHODS:
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.
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Anastomose chirurgicale artérioveineuse
/
Dialyse rénale
/
Artère ulnaire
/
Artère radiale
/
Membre supérieur
/
Ischémie
Type d'étude:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limites:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Pays/Région comme sujet:
Europa
Langue:
En
Journal:
J Vasc Access
Sujet du journal:
ANGIOLOGIA
Année:
2011
Type de document:
Article
Pays d'affiliation:
Royaume-Uni