SURGICAL-TREATMENT OF STEAL SYNDROME INDUCED BY ARTERIOVENOUS GRAFTS FOR HEMODIALYSIS

Objective. A rare but serious complication of angioaccess surgery for hemodialysis is the so called steal syndrome presenting as ischemia di stal to an arteriovenous fistula. The main problem of various surgical techniques to correct steal is subsequent thrombosis of the fistula o r persistence of distal ischemia. Interventions. This paper describes an unknown technique for correction of ischemic steal consisting of Li gation of the artery just distal to the take-off of the fistula and ar terial bypass from the artery proximal to the takeoff of the fistula t o the artery distal to ligation. Patients. Six patients with chronic r enal insufficiency (3 male, 3 female) with patent upper arm cephalic f istulas presented with severe hand ischemia. Results. Symptoms improve d in all 6 patients immediately after operation. Successful hemodialys is could be maintained using the original fistula. Conclusions. The de scribed technique is maybe the procedure of choice for the correction of fistula induced ischemic steal.