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Combined Endovascular Treatment with Distal Radial Artery Coil Embolization and Angioplasty in Steal Syndrome Associated with Forearm Dialysis Fistula

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Abstract

Purpose

The present study was performed to define the results of the endovascular treatment with angioplasty and distal radial artery embolization in ischemic steal syndrome associated with forearm arteriovenous accesses.

Method

The cases referred to our interventional radiology unit with symptoms and physical examination findings suggestive of ischemic steal syndrome were retrospectively evaluated first by Doppler ultrasonography, and then by angiography. Cases with proximal artery stenosis were applied angioplasty, and those with steal syndrome underwent coil embolization to distal radial artery.

Results

Of 589 patients who underwent endovascular intervention for dialysis arteriovenous fistulae (AVF)-associated problems, 6 (1.01 %) (5 female, 1 males; mean age 62 (range 41–78) with forearm fistula underwent combined endovascular treatment for steal syndrome. In addition to steal phenomenon, there were stenosis and/or occlusion in proximal radial and/or ulnar artery in 6 patients concurrently. Embolization of distal radial artery and angioplasty to proximal arterial stenoses were performed in all patients. Ischemic symptoms were eliminated in all patients and the AVF were in use at the time of study. In one patient, ischemic symptoms recurring 6 months later were alleviated by repeat angioplasty of ulnar artery.

Conclusion

In palmar arch steal syndrome affecting forearm fistulae, combined distal radial embolization and angioplasty is also an effective treatment method in the presence of proximal radial and ulnar arterial stenoses and occlusions.

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Authors and Affiliations

  1. Department of Radiology, School of Medicine, Pamukkale University, Denizli, Turkey

    Fahri Tercan & Ali Koçyiğit

  2. Department of Radiology, School of Medicine, Muğla Sıtkı Kocman University, Muğla, Turkey

    Bünyamin Güney

  3. Radyoloji AD, Pamukkale Üniversitesi Hastanesi, Çamlaraltı Mh. No:7, Pamukkale, 20070, Denizli, Turkey

    Fahri Tercan

Authors
  1. Fahri Tercan
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  2. Ali Koçyiğit
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  3. Bünyamin Güney
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Correspondence to Ali Koçyiğit.

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All authors declare that they have no conflict of interest.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Human and Animal Rights Statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

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Tercan, F., Koçyiğit, A. & Güney, B. Combined Endovascular Treatment with Distal Radial Artery Coil Embolization and Angioplasty in Steal Syndrome Associated with Forearm Dialysis Fistula. Cardiovasc Intervent Radiol 39, 1266–1271 (2016). https://doi.org/10.1007/s00270-016-1368-4

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  • DOI: https://doi.org/10.1007/s00270-016-1368-4

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