Acute Ischaemia of the Upper Extremity Following Graft Arteriovenous Fistula

  • M. Lazarides
  • V. Tzilalis


A 65-year old woman with end-stage renal disease and insulin-dependent diabetes was admitted for access construction in order to start haemodialysis. There was a lack of suitable veins to construct an arteriovenous (AV) fistula, and the patient underwent placement of a 6-mm polytetrafluoroethylene (PTFE) AV bridge graft between the brachial artery and the axillary vein in the left arm.


Brachial Artery Vascular Access Cephalic Vein Versus Fistula PTFE Graft 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Brescia MJ, Cimino JE, Appel K, Hurwich BJ. Chronic hemodialysis using venipuncture and a superficially created arteriovenous fistula. N Engl Med J Med 1966; 275: 1089–92.CrossRefGoogle Scholar
  2. 2.
    NKF-DOQI. Clinical practice guidelines for vascular access. Am J Kidney Dis 1997 (Suppl 3); 30: S150–89.Google Scholar
  3. 3.
    Marx AB, Landerman J, Harder FH. Vascular access for hemodialysis. Curr Probl Surg 1990; 27: 1–48.PubMedCrossRefGoogle Scholar
  4. 4.
    Windus DW. Permanent vascular access: a nephrologist’s view. Am J Kidney Dis 1993; 21: 457–71.PubMedGoogle Scholar
  5. 5.
    Feldman HI, Kobrin S, Wasserstein A. Hemodialysis vascular access morbidity. J Am Soc Nephrol 1996; 7: 523–35.PubMedGoogle Scholar
  6. 6.
    Marston WA, Criado E, Jaque PF, Mauro MA, Burnham SJ, Keagy BA. Prospective randomized comparison of surgical versus endovascular management of thrombosed dialysis access grafts. J Vasc Surg 1997; 26: 373–81.PubMedCrossRefGoogle Scholar
  7. 7.
    Gordon IL. Physiology of the arteriovenous fistula. In: Wilson SE, editor. Vascular access, principles and practice, 3rd edn. St Louis: Mosby, 1996; 29–41.Google Scholar
  8. 8.
    Schanzer H, Scladany M, Haimov M. Treatment of angioaccess-induced ischemia by revascularization. J Vasc Surg 1992; 16: 861–6.PubMedCrossRefGoogle Scholar
  9. 9.
    Lazarides MK, Staramos DN, Panagopoulos GN, Tzilalis VD, Eleftheriou GJ, Dayantas JN. Indications for surgical treatment of angioaccess-induced arterial steal. J Am Coll Surg 1998; 187: 422–6.PubMedCrossRefGoogle Scholar
  10. 10.
    Wilson SE. Complications of vascular access procedures. In: Wilson SE, editor. Vascular access, principles and practice, 3rd edn. St Louis: Mosby, 1996; 212–24.Google Scholar
  11. 11.
    Piotrovsky JJ, Alexander JJ, Yuhas JP. Vascular steal in hemodialysis: still unpredictable. Vasc Surg 1996; 30: 289–92.CrossRefGoogle Scholar
  12. 12.
    Hye RJ, Wolf YG. Ischemic monomelic neuropathy: an under-recognized complication of hemodialysis access. Ann Vasc Surg 1994; 8: 578–82.PubMedCrossRefGoogle Scholar
  13. 13.
    Schanzer H, Schwartz M, Harrington E, Haimov M. Treatment of ischemia due to “steal” by arteriovenous fistula with distal artery ligation and revascularization. J Vasc Surg 1988; 7: 770–3.PubMedGoogle Scholar
  14. 14.
    Haimov M, Schanzer H, Skladani M. Pathogenesis and management of upper-extremity ischemia following angioaccess surgery. Blood Purif 1996; 14: 350–4.PubMedCrossRefGoogle Scholar
  15. 15.
    Katz S, Kohl RD. The treatment of hand ischemia by arterial ligation and upper extremity bypass after angioaccess surgery. J Am Coll Surg 1996; 183: 239–42.PubMedGoogle Scholar
  16. 16.
    Berman SS, Gentile AT, Glickman MH, et al. Distal revascularization-interval ligation for limb salvage and maintenance of dialysis access in ischemic steal syndrome. J Vasc Surg 1997; 26: 393–404.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London 2003

Authors and Affiliations

  • M. Lazarides
  • V. Tzilalis

There are no affiliations available

Personalised recommendations