Steal syndrome

In severe occlusive disease of the subclavian artery (SCA) blood supply of the arm is mainly provided by reversed flow through the vertebral artery (VA) arising behind the obstruction. The so-called subclavian-steal syndrome consists of ischemic symptoms in the arm, especially after exercise, such as pain or numbness or coolness (Reivich et al. 1961). Consequently a diminished or delayed pulse in the radial artery or decreased blood pressure on the side of SCA stenosis can be palpated. Rarely neurological symptoms such as spells of dizziness may be brought about by exercise ofthe arm. Even more rare are ischemic brainstem strokes in subclavian-steal syndrome (Bornstein and Norris 1986). 

The innominate steal syndrome. Journal of Cardiovascular Surgery 20 481-486... 

Aggrenox) (-1- aspirin 50 mg) aggregation (complete MOA unknown) hypotension headache dizziness ("coronary steal syndrome") not specified in report... 

Fig. 6.15 Slow flow or subclavian steal syndrome. 2D TOF MRA source image (a) and MIP image of the TOF MRA (b) show absent flow and possible occlusion of the left vertebral artery (arrows in b). ceMRA (c), however, shows flow in this...

JARON I have a question about the steal syndrome in the coronary flow. Do you find it only in stenotic coronaries or can you play with the model in nonstenotic cases ... 

Considerable morbidity exists when dealing with vascular access (VA) creation. Native arteriovenous fistulae (AVF) are the desired VA for patients on dialysis due to their comparably low morbidity and fairly good long-term patency. However, they are also at risk for nonmaturation, stenosis, thrombosis, infection, aneurysm formation, and steal syndrome [ 1 ]. Fistula success is dependent on the center of access creation. Hence, the vascular surgeon s skills and decisions are key [2]. Furthermore, success is also determined by preoperative, technical, and postoperative factors that will be discussed in this chapter (fig. 1). 

Ehsan O, Bhattacharya D, Darvdsh A, Al-khaffaf H Extension technique a modified technique for brachio-cephalic fistula to prevent dialysis access-associated steal syndrome. Eur J Vase Endovasc Surg 2005 29 324-327. 

Distal revascularisation-interval ligation for 12 limb salvage and maintenance of dialysis access in ischemic steal syndrome. J Vase Surg 1997 26 393-404. 

Knox RC, Berman SS, Hughes JD, et al Distal revascularization-interval ligation a durable and effective treatment for ischemic steal syndrome after hemodialysis access. J Vase Surg 2002 36 250-256. 

Chemla E, Raynaud A, Carreres T, et al Preoperative assessment of the efficacy of distal radial artery ligation in treatment of steal syndrome complicating access for hemodialysis. Ann Vase Surg 1999 13 618-662. 

Callaghan CJ, Malhk M, Sivaprakasam R, lype S, Pettigrew GJ Treatment of dialysis access-associated steal syndrome with the revision using distal inflow technique. J Vase Access 2011 12 52-56. 

Yu SH, Cook PR, Canty TG, et al Hemodialysis-related steal syndrome predictive factors and response to treatment with the distal revascularization-interval ligation procedure. Ann Vase Surg 2008 22 210-214. 

Schur 1, Arnold WP Minimally Invasive Limited Ligation Endoluminal assisted Revision (MILLER) for treatment of dialysis access-associated steal syndrome. Kidney Int 2006 70 765-770. 

Minion DK, Moore Z, Endean E Revision using distal inflow a novel approach to dialysis-associated steal syndrome. Ann Vase Surg 2005 19 625-628. 

Thermaim F, Wollert U Proximalization of the arterial inflow new treatment of choice in patients with advanced dialysis shunt-associated steal syndrome Ann Vase Surg 2009 23 485-490. 

Inspection Each treatment Inspection of arm (hand and fingers), shoulder, breast neck and face Always compare with contralateral arm Normal healing of incision lines Patient has no complaints or symptoms related to AVF Signs of infection/occlusion (phlebitis) redness, warmth, swelling, erythema, pain Edema of limb, chest, neck or face Hematoma Collateral veins of neck, upper arm or shoulder Accessory veins Signs of steal syndrome pale, cyanotic, cold, decreased sensation, decreased function, absence of radial pulse Aneurysm... 

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