Vascular access steal syndrome

In nephrology, vascular access steal syndrome, also known less precisely as steal syndrome, refers to vascular insufficiency resulting from a poorly constructed arteriovenous fistula (Cimino fistula, or synthetic vascular graft-AV fistula).

Signs

 * Pallor
 * Diminished pulses (distal to the fistula)
 * Necrosis
 * Decreased wrist-brachial index (ratio of blood pressure measured in the wrist and the blood pressure measured in the upper arm)

Symptoms

 * Pain distal to the fistula.

Investigations

 * Arteriography

Treatment

 * Access ligation/vein banding (banding of the fistula or a vessel distal to the fistula to restrict flow through the fistula)