Abstract:
PURPOSE:Treatment options after arteriovenous fistula (AVF) associated steal include ligation, banding, and distal revascularization-interval ligation (DRIL). The purpose of this study was to evaluate the arterial pressure gradients in upper extremity steal syndrome. METHODS:Preoperative arteriography and sequential intra-arterial pressure readings were performed on consecutive AVF patients with hand ischemia. Analysis of variance (ANOVA) with repeated measures analyzed intersubject comparisons, and post hoc analysis identified anatomic locations with highest inflow pressures. RESULTS:Nine patients presented with ischemic hand symptoms after AVF. Pullback arterial pressure measurements revealed gradual increases in systolic and mean pressures as the catheter position was moved proximally from the AVF anastomosis. Post hoc analysis after ANOVA revealed higher axillary artery systolic pressure compared to proximal brachial artery (153 vs 116.8, P = .007). CONCLUSION:AVF-related steal syndrome decreases arterial inflow pressure of the affected extremity more proximally than previously thought. When performing a DRIL procedure, consideration should be given to placing the anastomosis as proximally as possible.
journal_name
Vasc Endovascular Surgjournal_title
Vascular and endovascular surgeryauthors
Reifsnyder T,Arnaoutakis GJdoi
10.1177/1538574410376450subject
Has Abstractpub_date
2010-11-01 00:00:00pages
650-3issue
8eissn
1538-5744issn
1938-9116pii
1538574410376450journal_volume
44pub_type
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journal_title:Vascular and endovascular surgery
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pub_type: 杂志文章,多中心研究
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journal_title:Vascular and endovascular surgery
pub_type: 杂志文章,随机对照试验
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pub_type: 杂志文章,meta分析,评审
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