Vascular access steal syndrome: Difference between revisions
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{{Infobox medical condition | |||
| name = Vascular access steal syndrome | |||
| synonyms = Dialysis-associated steal syndrome | |||
| field = [[Nephrology]], [[Vascular surgery]] | |||
| symptoms = [[Coldness]], [[pain]], [[numbness]], [[weakness]] in the affected limb | |||
| complications = [[Tissue necrosis]], [[ulceration]], [[gangrene]] | |||
| onset = After creation of [[arteriovenous fistula]] or [[arteriovenous graft]] | |||
| duration = Variable | |||
| causes = [[Arterial insufficiency]] due to diversion of blood flow | |||
| risks = [[Diabetes mellitus]], [[peripheral vascular disease]], [[elderly]] patients | |||
| diagnosis = [[Clinical examination]], [[Doppler ultrasound]], [[angiography]] | |||
| differential = [[Peripheral artery disease]], [[Raynaud's phenomenon]], [[carpal tunnel syndrome]] | |||
| prevention = Careful surgical planning, monitoring of blood flow | |||
| treatment = Surgical revision, banding, distal revascularization | |||
| prognosis = Good with timely intervention | |||
| frequency = 1-20% of patients with vascular access | |||
}} | |||
'''Vascular access steal syndrome''' (VASS) is a condition that occurs when blood flow is diverted from the distal extremity following the creation of a vascular access, such as an arteriovenous fistula or graft, for hemodialysis. This diversion of blood can lead to ischemia in the affected limb, causing symptoms ranging from mild discomfort to severe pain and tissue damage. | '''Vascular access steal syndrome''' (VASS) is a condition that occurs when blood flow is diverted from the distal extremity following the creation of a vascular access, such as an arteriovenous fistula or graft, for hemodialysis. This diversion of blood can lead to ischemia in the affected limb, causing symptoms ranging from mild discomfort to severe pain and tissue damage. | ||
== Pathophysiology == | == Pathophysiology == | ||
Vascular access steal syndrome arises when the vascular access shunts blood away from the distal circulation of the limb. This can occur when the fistula or graft has a high flow rate, reducing the perfusion pressure in the distal arteries. The condition is more common in patients with pre-existing peripheral vascular disease or diabetes, as these conditions can compromise the collateral circulation that might otherwise compensate for the reduced blood flow. | Vascular access steal syndrome arises when the vascular access shunts blood away from the distal circulation of the limb. This can occur when the fistula or graft has a high flow rate, reducing the perfusion pressure in the distal arteries. The condition is more common in patients with pre-existing peripheral vascular disease or diabetes, as these conditions can compromise the collateral circulation that might otherwise compensate for the reduced blood flow. | ||
== Symptoms == | == Symptoms == | ||
The symptoms of vascular access steal syndrome can vary in severity and may include: | The symptoms of vascular access steal syndrome can vary in severity and may include: | ||
* Coldness or pallor of the affected limb | * Coldness or pallor of the affected limb | ||
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* Weakness or muscle cramps | * Weakness or muscle cramps | ||
* In severe cases, tissue necrosis or ulceration | * In severe cases, tissue necrosis or ulceration | ||
== Diagnosis == | == Diagnosis == | ||
Diagnosis of vascular access steal syndrome typically involves a combination of clinical evaluation and diagnostic tests. Physical examination may reveal signs of ischemia, such as diminished pulses or skin changes. Doppler ultrasound or angiography can be used to assess blood flow and confirm the diagnosis. | Diagnosis of vascular access steal syndrome typically involves a combination of clinical evaluation and diagnostic tests. Physical examination may reveal signs of ischemia, such as diminished pulses or skin changes. Doppler ultrasound or angiography can be used to assess blood flow and confirm the diagnosis. | ||
== Treatment == | == Treatment == | ||
Treatment options for vascular access steal syndrome depend on the severity of the condition. Mild cases may be managed conservatively with observation and symptomatic treatment. More severe cases may require surgical intervention, such as banding of the fistula, revision of the access, or creation of a new access site. In some cases, distal revascularization procedures may be necessary to restore adequate blood flow to the affected limb. | Treatment options for vascular access steal syndrome depend on the severity of the condition. Mild cases may be managed conservatively with observation and symptomatic treatment. More severe cases may require surgical intervention, such as banding of the fistula, revision of the access, or creation of a new access site. In some cases, distal revascularization procedures may be necessary to restore adequate blood flow to the affected limb. | ||
== Prevention == | == Prevention == | ||
Preventive measures for vascular access steal syndrome include careful planning of the vascular access site, taking into account the patient's vascular anatomy and risk factors. Preoperative assessment with imaging studies can help identify patients at risk and guide the choice of access site and technique. | Preventive measures for vascular access steal syndrome include careful planning of the vascular access site, taking into account the patient's vascular anatomy and risk factors. Preoperative assessment with imaging studies can help identify patients at risk and guide the choice of access site and technique. | ||
== Related pages == | == Related pages == | ||
* [[Arteriovenous fistula]] | * [[Arteriovenous fistula]] | ||
Latest revision as of 03:51, 4 April 2025
| Vascular access steal syndrome | |
|---|---|
| Synonyms | Dialysis-associated steal syndrome |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Coldness, pain, numbness, weakness in the affected limb |
| Complications | Tissue necrosis, ulceration, gangrene |
| Onset | After creation of arteriovenous fistula or arteriovenous graft |
| Duration | Variable |
| Types | N/A |
| Causes | Arterial insufficiency due to diversion of blood flow |
| Risks | Diabetes mellitus, peripheral vascular disease, elderly patients |
| Diagnosis | Clinical examination, Doppler ultrasound, angiography |
| Differential diagnosis | Peripheral artery disease, Raynaud's phenomenon, carpal tunnel syndrome |
| Prevention | Careful surgical planning, monitoring of blood flow |
| Treatment | Surgical revision, banding, distal revascularization |
| Medication | N/A |
| Prognosis | Good with timely intervention |
| Frequency | 1-20% of patients with vascular access |
| Deaths | N/A |
Vascular access steal syndrome (VASS) is a condition that occurs when blood flow is diverted from the distal extremity following the creation of a vascular access, such as an arteriovenous fistula or graft, for hemodialysis. This diversion of blood can lead to ischemia in the affected limb, causing symptoms ranging from mild discomfort to severe pain and tissue damage.
Pathophysiology[edit]
Vascular access steal syndrome arises when the vascular access shunts blood away from the distal circulation of the limb. This can occur when the fistula or graft has a high flow rate, reducing the perfusion pressure in the distal arteries. The condition is more common in patients with pre-existing peripheral vascular disease or diabetes, as these conditions can compromise the collateral circulation that might otherwise compensate for the reduced blood flow.
Symptoms[edit]
The symptoms of vascular access steal syndrome can vary in severity and may include:
- Coldness or pallor of the affected limb
- Pain or discomfort, particularly during exercise or at rest
- Numbness or tingling sensations
- Weakness or muscle cramps
- In severe cases, tissue necrosis or ulceration
Diagnosis[edit]
Diagnosis of vascular access steal syndrome typically involves a combination of clinical evaluation and diagnostic tests. Physical examination may reveal signs of ischemia, such as diminished pulses or skin changes. Doppler ultrasound or angiography can be used to assess blood flow and confirm the diagnosis.
Treatment[edit]
Treatment options for vascular access steal syndrome depend on the severity of the condition. Mild cases may be managed conservatively with observation and symptomatic treatment. More severe cases may require surgical intervention, such as banding of the fistula, revision of the access, or creation of a new access site. In some cases, distal revascularization procedures may be necessary to restore adequate blood flow to the affected limb.
Prevention[edit]
Preventive measures for vascular access steal syndrome include careful planning of the vascular access site, taking into account the patient's vascular anatomy and risk factors. Preoperative assessment with imaging studies can help identify patients at risk and guide the choice of access site and technique.
