Dialysis access steal syndromes

Gary W. Lemmon, Michael P. Murphy

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Dialysis-associated steal syndromes remain a vexing problem for the busy vascular access surgeon. Those factors associated with ischemia include the elderly, diabetic, female, preexisting cardiac disease and brachial anastomosis, and previous ipsilateral access. A constellation of symptoms and findings based on underlying arterial disease and flow characteristics are necessary to provide prompt diagnosis and initiate treatment. Although a digital brachial index (DBI) >1 and transcutaneous oxygen tension (TCPO2) measurements >60 mm Hg accurately predict a patient not at risk, no DBI or TCPO2 levels below that accurately predict if a patient will develop dialysis-associated ischemia. The goal of the vascular access surgeon is to provide prompt recognition and treatment of the disorder to maximize both limb salvage and access salvage. Continuation of angio access in the same extremity can be accomplished in most individuals.

Original languageEnglish (US)
Pages (from-to)36-39
Number of pages4
JournalPerspectives in vascular surgery and endovascular therapy
Volume21
Issue number1
DOIs
StatePublished - May 8 2009

Keywords

  • Dialysis access
  • Digital brachial index
  • Fistula
  • Ischemia

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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