Steal phenomenon in radiocephalic arteriovenous fistula. In vitro haemodynamic and electrical resistance simulation studies

Abstract

an electrical resistance model of a radiocephalic AVF has been validated with an in vitro pulsatile flow circuit. One of the benefits of this model is that it can be easily analysed using standard circuit simulation software. The model also provide insights into the possible haemodynamics consequences of creating an AVF with or without the presence of a stenosis in the arterial segments.

Side Branch Ligation for Haemodialysis-access-induced Distal Ischaemia

“…6,19e22 It should be appreciated that the haemodynamic effect of just angiographically 'minor' stenoses may be substantial in a high-flow system as typically observed in a dialysis arm. 3,5,23 If a beneficial effect of angioplasty is doubted, intraluminal pressure measurements may quantify the haemodynamic effect of such a limited stenosis. 24 Interestingly, an inflow stenosis was not present in any of the 22 patients undergoing angiography in the 7-year study period in our institution.…”

Current tools for prediction of arteriovenous fistula outcomes

“…A reflex increase in cardiac output allows for this distal tissue perfusion and maturation of the fistula which is frequently complemented by retrograde arterial flow [ 4 ]. Where retrograde flow is excessive, steal syndrome may occur characterized by distal neuralgia and eventually peripheral limb ischaemia [ 5 , 6 ].…”

Applicability of an entry flow model of the brachial artery for flow models of the hemodialysis fistula

“…4 They can also lead to hand ischemia (steal syndrome) and associated morbidity. 8–10 Therefore, prevention and treatment of such problems require a thorough understanding of these factors. This understanding cannot be easily obtained from clinical studies because practical limits exist on the data that can be collected from patients and because vessel geometries are variable.…”