Ces radiol. 2013, 67(2):125-129

Percutaneous treatment of steal syndrome of hand with A-V shuntCase report

Jan Kaván1, Jiří Křivánek1, Marcela Slavíková2, Andrea Kmentová1
1 Radiodiagnostická klinika 1. LF UK a VFN, Praha
2 II. chirurgická klinika kardiovaskulární chirurgie 1. LF UK a VFN, Praha

Aim: We present three cases of patients with hand ischemia which was associated with dialysis arteriovenous fistula and which was treated by embolization of distal radial artery.

Methods: During years 2009-2012 in our department we performed embolization of radial artery distal to the anastomosis of dialysis fistula in 4 patients with steal syndrome. These were three women and one man, average age 69 years. In all cases we implanted embolization spirals to radial artery distal to the anastomosis of arteriovenous fistula.

Results: In all patients the symptoms of steal syndrome disappeared, three patients are symptom-free until now. In one patient a spontaneous recanalization of the treated part of the artery occurred 14 days after the embolization and clinical symptoms of steal syndrome returned after 5 months. Permanent result in this case with no clinical symptoms was achieved by re-embolization by Amplatz plug.

Conclusion: The embolization of radial artery distal to the arteriovenous anastomosis of dialysis fistula is an effective way to treat steal syndrome caused by the presence of the shunt. However we need to consider that this is a permanent closure of radial artery and there is a risk of hand ischemia in case of occlusion of the other arteries supplying hand.

Keywords: dialysis fistula, embolization, hand ischemia, steal phenomenon, steal syndrome

Accepted: April 18, 2013; Published: June 1, 2013  Show citation

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Kaván J, Křivánek J, Slavíková M, Kmentová A. Percutaneous treatment of steal syndrome of hand with A-V shunt. Ces radiol. 2013;67(2):125-129.
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