Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/S1677-54492012000200015
Jornal Vascular Brasileiro
Case Report

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

Treatment of hemodialysis access steal syndrome by distal revascularization arterial ligature: report of three cases

Afonso César Polimanti; Sidnei José Galego; Rafael Vilhena de Carvalho Fürst; Gabriela da Silveira Moraes; Rafael Camacho da Silva Barbosa; Sônia Regina Silveira; Maria do Carmo Silva Neves Kawhage; João Antônio Correa

http://dx.doi.org/10.1590/S1677-54492012000200015 J Vasc Bras, vol.11, n2, p.158-161, 2012
PDF Português
PDF English
SciELO
Downloads: 12
Views: 1440

Resumo

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.

Palavras-chave

derivação arteriovenosa cirúrgica, isquemia, hemodiálise, fístula arteriovenosa, terapêutica

Abstract

Arteriovenous fistulas for hemodialysis may present long-term complications. Among the least frequent complications, there is the steal syndrome. The authors report the experience of three patients that presented with critical limb ischemia years after the access confection of brachiocephalic arteriovenous fistulas, with little response to clinical treatment. Distal revascularization interval ligation was performed in all cases, with good outcome. Due to small quantity of the cases, we decided to report the experience and review the literature on the subject.

Keywords

arteriovenous shunt, ischemia, hemodialysis, arteriovenous fistula, therapeutic

References

Sesso R de C, Lopes AA, Thome FS, Lugon JR, Burdmann EA. Brazilian dialysis census, 2009. J Bras Nefrol. 2010;32:374-8.

Anel RL, Yevzlin AS, Ivanovich P. Vascular access and patient outcomes in hemodialysis: questions answered in recent literature. Artif Organs. 2003;27:237-41.

Yiltok SJ, Orkar KS, Agaba EI. Arteriovenous fistula for patients on long term haemodialysis in jos, Nigeria. Niger Postgrad Med J. 2005;12:6-9.

Lazarides MK, Staramos DN, Kopadis G, Maltezos C, Tzilalis VD, Georgiadis GS. Onset of arterial 'steal' following proximal angioaccess: immediate and delayed types. Nephrol Dial Transplant. 2003;18:2387-90.

Mickley V. Steal syndrome: strategies to preserve vascular access and extremity. Nephrol Dial Transplant. 2008;23:19-24.

Katz S, Kohl RD. The treatment of hand ischemia by arterial ligation and upper extremity bypass after angioaccess surgery. J Am Coll Surg. 1996;183:239-42.

Knox RC, Berman SS, Hughes JD, Gentile AT, Mills JL. Distal revascularization-interval ligation: a durable and effective treatment for ischemic steal syndrome after hemodialysis access. J Vasc Surg. 2002;36:250-5.

Linardi F, Linardi FF, Bevilacqua JL, Morad JFM, Costa JA. Tratamento cirúrgico da "síndrome do roubo" em acesso vascular para hemodiálise com revascularização distal e ligadura arterial. J Vasc Bras. 2006;5:117-22.

Yu SH, Cook PR, Canty TG, McGinn RF, Taft PM, Hye RJ. Hemodialysis-related steal syndrome: predictive factors and response to treatment with the distal revascularization-interval ligation procedure. Ann Vasc Surg. 2008;22:210-4.

Galego SJ, Goldenberg S, Ortiz JP, De Oliveira Gomes P, Ramacciotti E. Comparative blood flow study of arteriovenous fistulae in canine femoral arteries: modified latero-lateral and end-lateral techniques. Artif Organs. 2000;24:235-40.

Malik J, Tuka V, Kasalova Z. Understanding the dialysis access steal syndrome: A review of the etiologies, diagnosis, prevention and treatment strategies. J Vasc Access. 2008;9:155-66.

Goff CD, Sato DT, Bloch PH. Steal syndrome complicating hemodialysis access procedures: can it be predicted?. Ann Vasc Surg. 2000;14:138-44.

Malgor RD, Yoshida RdA, Sobreira ML, Giannini Mn, Yoshida WB, Rollo HA. Tratamento da síndrome do roubo devido a fístula arteriovenosa para hemodiálise em membro inferior por meio da técnica de ligadura arterial e revascularização distal (técnica de DRIL). J Vasc Bras. 2007;6:288-92.

Kirksey L. Ischemic monomelic neuropathy: an underappreciated cause of pain and disability following vascular access surgery. J Vasc Access. 2010;11:165-8.

Zamora JL, Rose JE, Rosario V, Noon GP. Hemodialysis-associated carpal tunnel syndrome: A clinical review. Nephron. 1985;41:70-4.

Wixon CL, Hughes JD, Mills JL. Understanding strategies for the treatment of ischemic steal syndrome after hemodialysis access. J Am Coll Surg. 2000;191:301-10.

Wilson SW, Pollard RE, Lees VC. Management of carpal tunnel syndrome in renal dialysis patients using an extended carpal tunnel release procedure. J Plast Reconstr Aesthet Surg. 2008;61:1090-4.

Zamani P, Kaufman J, Kinlay S. Ischemic steal syndrome following arm arteriovenous fistula for hemodialysis. Vasc Med. 2009;14:371-6.

Jackson KL, Charpentier KP. Quantitative banding for steal syndrome secondary to arteriovenous fistulae. Ann R Coll Surg Engl. 2010;92.

Callaghan CJ, Mallik M, Sivaprakasam R, Iype S, Pettigrew GJ. Treatment of dialysis access-associated steal syndrome with the "revision using distal inflow" technique. J Vasc Access. 2011;12:52-6.

Gupta N, Yuo TH, Konig G 4th. Treatment strategies of arterial steal after arteriovenous access. J Vasc Surg. 2011;54:162-7.

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
5ddd37f60e8825f90d1da3e9 jvb Articles
1677-7301 (Electronic)
J Vasc Bras ©2024 All rights reserved.

J Vasc Bras

Share this page
Page Sections