Ischemic steal syndrome following arm arteriovenous fistula for hemodialysis

Zamani, Payman; Kaufman, James S.; Kinlay, Scott

doi:10.1177/1358863x09102293

Cited by 50 publications

(52 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…An AVF can cause significant local and general changes in the bloodstream. In fact, retrograde flow in the radial artery occurs in more than 70% of patients with AVF, which, however, does not cause ischemia in subjects with normal blood circulation [15] . Ischemic syndrome in physiological conditions results from a fall in blood pressure in the periphery and failure of compensatory vasodilatation [16] .…”

Section: Hemodynamic Impact On the Development Of Distal Ischemiamentioning

confidence: 99%

Arteriovenous fistulas and digital hypoperfusion ischemic syndrome in patients on hemodialysis

Stolić¹

2013

WJN

View full text Add to dashboard Cite

AIM:To determine survival parameters as well as characteristics of patients with this syndrome. METHODS:The investigation was conducted over a period of eight years, as a prospective, non-randomized, clinical study which included 204 patients, treated by chronic hemodialysis. Most patients received hemodialysis 12 h per week. As vascular access for hemodialysis all subjects had an arteriovenous fistulae. Based on surveys the respondents were divided into groups of patients with and without digital hypoperfusion ischemic syndrome. Gender, demographic and anthropometric characteristics, together with comorbidity and certain habits, were recorded. During this period 34.8% patients died. RESULTS:Patients with digital hypoperfusion ischemic syndrome were older than those without ischemia (P = 0.01). Hemodialysis treatment lasted significantly longer in the patients with digital hypoperfusion ischemic syndrome (P = 0.02). The incidence of cardiovascular disease (P < 0.001) and diabetes mellitus (P = 0.01), as well as blood flow through the arteriovenous fistula (P = 0.036), were higher in patients with digital hypoperfusion ischemic syndrome. Statistically significant differences also existed in relation to oxygen saturation (P = 0.04). Predictive parameters of survival for patients with digital hypoperfusion ischemic syndrome were: adequacy of hemodialysis (B = -3.604, P < 0.001), hypertension (B = -0.920, P = 0.018), smoking (B = -0.901, P = 0.049), diabetes mellitus (B = 1.227, P = 0.005), erythropoietin therapy (B = 1.274, P = 0.002) and hemodiafiltration (B = -1.242, P = 0.033). KaplanMeier survival analysis indicated that subjects with and without digital hypoperfusion ischemic syndrome differed regarding the length of survival (P < 0.001), i.e. , patients with confirmed digital hypoperfusion ischemic syndrome died earlier. CONCLUSION:Survival was significantly longer in the patients without digital hypoperfusion ischemic syndrome.© 2013 Baishideng. All rights reserved.Key words: Digital hypoperfusion ischemic syndrome; Predictive parameters; Survival; Arteriovenous fistula; Hemodialysis Core tip: In order to prevent the occurrence of distal hypoperfusion syndrome, is important identification of risk factors. Problem is the absence of objective indicators of distal ischemia, which is main reason why large proportion our patients have of this symptoms. Our patients with these symptoms were significantly older, which confirms older age as a factor that characterizes BRIEF ARTICLE 26May 6, 2013|Volume 2|Issue 2| WJN|www.wjgnet.com patients with distal hypoperfusion syndrome. We have confirmed greater incidence of diabetes mellitus and smokers among the patients with distal hypoperfusion syndrome. Quality of dialysis, diabetes mellitus, erythropoietin therapy, smokers and hemodiafiltration has predictive value for survival of patients with distal ischemia.Stolic RV, Trajkovic GZ, Miric DJ, Kisic B, Djordjevic Z, Azanjac GL, Stanojevic MS, Stolic DZ. Arteriovenous fistulas and digital hypoperfusion ischemic ...

show abstract

Section: Hemodynamic Impact On the Development Of Distal Ischemiamentioning

confidence: 99%

Arteriovenous fistulas and digital hypoperfusion ischemic syndrome in patients on hemodialysis

Stolić¹

2013

WJN

View full text Add to dashboard Cite

show abstract

“…Arteriovenöz fistülde, tromboz başta olmak üzere kanama, enfeksiyon, anevrizma konjestif kalp yetmezliği ve distal iskemi gibi komplikasyonlar görülür (5) .…”

Section: Discussionunclassified

“…Ancak bu çalma sendromu her zaman el iskemisine neden olmaz. İskemik komplikasyonlar zayıf distal kan akımı nedeniyle ender olmakla birlikte, bazen parmakların ve elin amputasyonuna neden olabilmektedir (6) . Olgumuzda kolda ilerleyen ödem, uyuşukluk ve renk değişikliği mevcuttu.…”

Section: Discussionunclassified

UPPER EXTREMITY DISTAL ISCHEMIA ARTERIOVENOUS FISTULA; A Case Report

Teker¹,

İnan²

2016

Okmeydani Medical Journal

View full text Add to dashboard Cite

ÖZ GİRİŞSon dönem böbrek yetmezlikli hastalar böbrek transplantasyonu planlanana kadar yaşamlarının devamı için hemodialize gerek duyarlar. Hemodializ için de uzun süre açık kalan arteriovenöz fistül (AVF) gerekmektedir (1) .Arteriovenöz fistülde amaç yaşam kalitesini yükselt-mek olsa da fistül açılan kolda distalde kan akımında azalmaya neden olarak ender görülse, distal iskemi gibi komplikasyonlar görülebilir (2) .Arteriovenöz fistül sonrası görülen distal iskemi tedavisinde; arteriovenöz fistül ligasyonu, distal revaskülarizasyon-interval ligasyonu, banding yön-temi gibi cerrahi metotlar uygulanabilir (3) .Bu çalışmamızda amacımız AVF komplikasyonu olarak gelişen üst ekstremite iskemisinde uyguladığımız cerrahi tedavi yöntemini sunmaktır. OLGUKronik böbrek yetmezliği nedeniyle 5 yıldır diyalize giren, sağ koldan toplam üç defa A-V fistül ameliyatı olan ve en son 6 ay önce brakial arter-sefalik ven arasında A-V fistül açılmış olan atmış iki yaşında erkek hasta, son iki aydır sağ kolda ödem, uyuşukluk ve renk değişikliği nedeniyle kliniğimize başvurdu (Resim 1).Fizik muayenesinde; sağ kolunda belirgin ödem, renk değişikliği ve subkutan pulsatil anevrizmal dilatasyonu tespit edildi. Elle yapılan muayenesinde sağ radial nabız non-palpabl iken fistül geçici kapatıldığında

show abstract

“…Doppler ultrasonography is able to identify the cause of ischemia by showing flow inversion in the brachial artery distal to the anastomosis, and reduced flow in the distal arteries of the forearm. It is important for surgical planning to show the distal arterial outflow and the assessment of palmar arch patency [16][17][18] . Many techniques for the treatment of ischemic syndrome in patients with upper fistulas have been described, and they aim to decrease the AVF flow, thus improving distal ischemia and decreasing flow inversion in the distal artery 8,[19][20][21] .…”

Section: Discussionmentioning

confidence: 99%

Tratamento da síndrome de roubo de fístula arteriovenosa pela técnica de revascularização distal e ligadura arterial: relato de três casos

et al. 2012

View full text Add to dashboard Cite

Fístulas arteriovenosas para hemodiálise podem apresentar complicações a longo prazo. Entre as complicações mais raras, há a isquemia distal por síndrome de roubo. Os autores relataram a experiência de três casos de pacientes portadores de fístulas braquiocefálicas, em funcionamento por longo prazo e que evoluíram com isquemia crítica do membro, sem resposta com tratamento clínico. Com o intuito de tratar esta afecção e preservar o acesso vascular, optou-se pela realização da revascularização distal interposta por ligadura arterial. Devido à raridade dos casos, relatou-se a experiência e apresentou-se uma revisão de literatura.

show abstract

Ischemic steal syndrome following arm arteriovenous fistula for hemodialysis

Cited by 50 publications

References 25 publications

Arteriovenous fistulas and digital hypoperfusion ischemic syndrome in patients on hemodialysis

Arteriovenous fistulas and digital hypoperfusion ischemic syndrome in patients on hemodialysis

UPPER EXTREMITY DISTAL ISCHEMIA ARTERIOVENOUS FISTULA; A Case Report

Tratamento da síndrome de roubo de fístula arteriovenosa pela técnica de revascularização distal e ligadura arterial: relato de três casos

Contact Info

Product

Resources

About