Steal Syndrome Management with Saving Hemodialysis Access

Hemodialysis access creation is one of the most commonly performed operations in peripheral vascular surgery. Minimal shunt volume flow rates in adult patients with antilogous shunts range between 300 and 500 ml /min are adequate for dialysis purposes and maintain the patency of the fistula. With an inappropriately high shunt flow, cardiac complications from volume overload and dialysis access-associated steal syndrome may occur. Hand ischemia due to arterial steal syndrome is an infrequent, but potentially serious complication of hemodialysis access procedure. Several surgical options have been described for steal syndrome correction as ligation of the access and banding of the fistula. These procedures are associated with a certain incidence of access loss. Increased popularity of distal artery Ligation and revascularization as a new option for management of steal syndrome with preservation of the hemodialysis access is a challenge.