Steal Syndrome after Brachiocephalic Fistula for Vascular Access: Correction with a New Simple Surgical Technique

Abstract

Steal syndrome is the condition of arterial insufficiency distal to a permanent haemodialysis fistula. Three treatment options have been recommended: ligation of the fistula, banding of the fistula, and distal revascularization. We report an alternative simple surgical technique for correction of steal syndrome. Two patients were treated for steal syndrome after brachiocephalic fistula operation. The treatment of the steal syndrome was done by interponating an ePTFE graft loop tunnelated subcutaneously in the upper arm. At follow-up one year later both fistula were patent without any reoperation and with normal flow at haemodialysis. There were no symptoms of steal. This new method for correction of steal syndrome seems to be an attractive alternative.