Usefulness of skin perfusion pressure for dialysis-associated steal syndrome

Yamamoto, Yuya; Nakamura, Junichi; Nakayama, Yuji; Hino, H; Kakujo, Yasuko; Mune, Sachiko

doi:10.4009/jsdt.46.1159

Cited by 2 publications

(3 citation statements)

References 5 publications

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“…The mean SPP level of the upper limb of the patients is approximately 95–100 mmHg in our study. Thus, these data are in agreement with previous studies of hemodialysis patients (85.8 ± 25.0 mmHg) …”

Section: Discussionsupporting

confidence: 94%

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Change in skin perfusion pressure after the creation of upper limb arteriovenous fistula for maintenance hemodialysis access

Sueki

Sakurada

Miyamoto

et al. 2014

Hemodialysis International

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Arteriovenous fistula (AVF) is the most important vascular access method for hemodialysis (HD). However, ischemic steal syndrome occasionally develops. This study evaluated the change in skin perfusion pressure (SPP) after the creation of upper limb AVF and analyzed the relationship between blood flow measurements and the change in SPP. The subjects included 21 patients who underwent radiocephalic AVF creation for the first time between November 2012 and September 2013. We measured SPP on the palm side of the third finger of both hands and assessed blood flow measurements using ultrasound examination before and after the creation of AVF. The subjects consisted of 15 men and 6 women (average age: 65.3 ± 12.7 years, including 12 diabetic patients). Observational period between before and after surgery was 4.9 ± 5.2 days. None of the patients had ischemic steal syndrome after the creation of AVF. Skin perfusion pressure tended to decrease after creation of AVF on the finger of AVF side (100.0 ± 20.9 vs. 87.9 ± 26.5 mmHg, P = 0.063). In contrast, SPP did not change in the limb without AVF (97.9 ± 20.7 vs. 101.0 ± 19.4 mmHg, P = 0.615). The rate of change in SPP was significantly decreased on the finger of AVF side compared with that of limb without AVF (0.055% vs. -0.112%, P = 0.014). There was no correlation between the change in SPP and blood flow measurements. Skin perfusion pressure is possible to detect ischemic steal syndrome after the creation of upper limb AVF.

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Section: Discussionsupporting

confidence: 94%

“…Yamamoto et al . reported that the cut‐off value of dialysis‐associated steal syndrome was 57.5 mmHg (sensitivity 87.1%, specificity 95.3%) from the results of measurement of SPP in 106 dialysis patients.…”

Section: Discussionmentioning

confidence: 99%

Change in skin perfusion pressure after the creation of upper limb arteriovenous fistula for maintenance hemodialysis access

Sueki

Sakurada

Miyamoto

et al. 2014

Hemodialysis International

View full text Add to dashboard Cite

show abstract

“…In a study by Yamamoto et al 22 in 2013, postoperative SPP was measured in 106 vascular access patients, and interviews were conducted to investigate the symptoms of ARHI and examine the correlation between SPP and postoperative ARHI. They reported that ARHI occurred when the SPP was <57.5 mmHg (sensitivity, 87.1%; specificity, 95.3%).…”

Section: Discussionmentioning

confidence: 99%

Skin perfusion pressure for predicting access-related hand ischemia following arteriovenous fistula surgery based on the brachial artery

et al. 2021

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Background: Access-related hand ischemia (ARHI) is a major complication of arteriovenous fistula (AVF). This study aimed to assess the predictive efficacy of skin perfusion pressure (SPP) measurement for ARHI by examining the relationship between SPP and ARHI development and progression after AVF surgery. Methods: Twenty-five patients (16 men and 9 women) who underwent AVF surgery based on the brachial artery between January 2018 and December 2018 were included. The pre- and postoperative SPP values were measured on the day of surgery. ARHI occurrence and severity were measured within 3 days and at 6 months after surgery. Receiver operating characteristic curve analysis was used to evaluate the prediction model of ARHI, and the cutoff points for the calculated coefficients were determined. Results: There was a significant correlation between the occurrence of immediate ARHI and the SPP gradient ( p = 0.024). An SPP gradient value >50 mmHg had sensitivity and specificity values of 53.85% and 91.67%, respectively, in predicting the occurrence of immediate ARHI. A postoperative SPP <48 mmHg was significantly correlated with the occurrence of 6-month ARHI ( p = 0.005), with sensitivity and specificity values of 71.43% and 83.33%, respectively. Conclusion: The SPP gradient and postoperative SPP values may be effective clinical predictors of ARHI occurring immediately and 6 months after surgery, respectively, with high specificity. These findings could allow clinicians to diagnose and begin early interventions to help prevent ischemic tissue damage in hemodialysis patients following AVF surgery.

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Usefulness of skin perfusion pressure for dialysis-associated steal syndrome

Cited by 2 publications

References 5 publications

Change in skin perfusion pressure after the creation of upper limb arteriovenous fistula for maintenance hemodialysis access

Change in skin perfusion pressure after the creation of upper limb arteriovenous fistula for maintenance hemodialysis access

Skin perfusion pressure for predicting access-related hand ischemia following arteriovenous fistula surgery based on the brachial artery

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