%0 Journal Article
%T Resultados del tratamiento con revascularizaci¨®n distal y ligadura intermedia, de la isquemia de mano despu¨¦s de acceso vascular para hemodi¨¢lisis
%A Rojas N
%A Reginald
%A Rojas S G
%A Andr¨¦s
%A Mart¨ªnez H
%A Rodrigo
%J Revista chilena de cirug¨ªa
%D 2012
%I Scientific Electronic Library Online
%R 10.4067/S0718-40262012000300005
%X background: the creation of vascular accesses for hemodialysis can cause distal ischemia and steal syndromes. aim: to assess the effectiveness of the technique of distal revascularization-interval ligation to alleviate distal ischemia and preserve vascular access. material and methods: retrospective review of medical records, identifying 23 patients (13 women, aged between 24 and 79 years), with distal ischemia secondary to a vascular access for hemodialysis, that were treated with distal revascularization-interval liga-tion. patient characteristics and outcome of the surgical procedure were recorded. results: fourteen patients were diabetic and 15 had high blood pressure. all had the vascular access in the elbow, 20 were done with vein and three were prosthetic. steal appeared in a lapse ranging from hours to six years after performing the procedure. in 14 patients it appeared before 12 months. revascularization was performed between 1 day and three months after the appearance of the steal syndrome. seventeen patients (74%) had a substantial relief of ischemic symptoms, with healing of ulcers and digital amputations. three patients died soon after the procedure (13%). in two the pain persisted, requiring a banding of the access, that finally became thrombosed. one patient required a distal forearm amputation. thirteen patients (56%) had a late death after the procedure. after revascularization, the vascular accesses were used for a mean of two years. conclusions: revascularization-interval ligation relieves distal ischemia and maintains the patency of the vascular access for hemodialysis. patients with steal syndrome secondary to vascular access are of high risk.
%K steal syndrome
%K hemodialysis
%K vascular access.
%U http://www.scielo.cl/scielo.php?script=sci_abstract&pid=S0718-40262012000300005&lng=en&nrm=iso&tlng=en