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The MILLER banding procedure is an effective method for treating dialysis-associated steal syndrome.MILLER 带扎术是治疗透析相关窃血综合征的有效方法。
Kidney Int. 2010 Feb;77(4):359-66. doi: 10.1038/ki.2009.461. Epub 2009 Dec 9.
2
Plication as primary treatment of steal syndrome in arteriovenous fistulas.折叠术作为动静脉内瘘窃血综合征的主要治疗方法。
Ann Vasc Surg. 2009 Jan-Feb;23(1):103-7. doi: 10.1016/j.avsg.2008.08.009. Epub 2008 Sep 21.
3
Midterm outcome after the distal revascularization and interval ligation (DRIL) procedure.远端血管重建与分期结扎（DRIL）手术后的中期结果。
J Vasc Surg. 2008 Oct;48(4):926-32; discussion 932-3. doi: 10.1016/j.jvs.2008.05.028. Epub 2008 Jul 18.
4
Hemodialysis-related steal syndrome: predictive factors and response to treatment with the distal revascularization-interval ligation procedure.血液透析相关盗血综合征：预测因素及对远端血管重建-间隔结扎术治疗的反应
Ann Vasc Surg. 2008 Mar;22(2):210-4. doi: 10.1016/j.avsg.2007.12.005.
5
Distal revascularization and interval ligation (DRIL) procedure for the treatment of ischemic steal syndrome after arm arteriovenous fistula.
Ann Vasc Surg. 2007 Jul;21(4):468-73. doi: 10.1016/j.avsg.2006.08.006. Epub 2007 Apr 6.
6
Hemodynamics of distal revascularization-interval ligation.远端血管重建-间隔结扎术的血流动力学
Ann Vasc Surg. 2005 Mar;19(2):199-207. doi: 10.1007/s10016-004-0162-y.
7
Prediction of arteriovenous access steal syndrome utilizing digital pressure measurements.利用数字压力测量预测动静脉内瘘窃血综合征
Vasc Endovascular Surg. 2003 May-Jun;37(3):179-84. doi: 10.1177/153857440303700304.
8
Treatment of steal syndrome complicating a proximal arteriovenous bridge graft fistula by simple distal artery ligation without revascularization using intraoperative pressure measurements.
Ann Vasc Surg. 2003 May;17(3):320-2. doi: 10.1007/s10016-001-0262-x. Epub 2003 Apr 22.
9
Do preoperative finger pressures predict early arterial steal in hemodialysis access patients? A prospective analysis.
J Vasc Surg. 2002 Aug;36(2):351-6. doi: 10.1067/mva.2002.125848.
10
Distal revascularization-interval ligation: a durable and effective treatment for ischemic steal syndrome after hemodialysis access.远端血管重建-间隔结扎术：一种治疗血液透析通路后缺血性窃血综合征的持久且有效的方法。
J Vasc Surg. 2002 Aug;36(2):250-5; discussion 256. doi: 10.1067/mva.2002.125025.

上肢动静脉内瘘盗血综合征的动脉压力梯度：治疗意义

Arterial pressure gradient of upper extremity arteriovenous access steal syndrome: treatment implications.

作者信息

Reifsnyder Thomas, Arnaoutakis George J

机构信息

Division of Vascular Surgery, Johns Hopkins Bayview Medical Center, Johns Hopkins Medical Institutions, Baltimore, MD, USA.

出版信息

Vasc Endovascular Surg. 2010 Nov;44(8):650-3. doi: 10.1177/1538574410376450. Epub 2010 Jul 30.

DOI:10.1177/1538574410376450
PMID:20675320
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3119858/
Abstract

PURPOSE

Treatment options after arteriovenous fistula (AVF) associated steal include ligation, banding, and distal revascularization-interval ligation (DRIL). The purpose of this study was to evaluate the arterial pressure gradients in upper extremity steal syndrome.

METHODS

Preoperative arteriography and sequential intra-arterial pressure readings were performed on consecutive AVF patients with hand ischemia. Analysis of variance (ANOVA) with repeated measures analyzed intersubject comparisons, and post hoc analysis identified anatomic locations with highest inflow pressures.

RESULTS

Nine patients presented with ischemic hand symptoms after AVF. Pullback arterial pressure measurements revealed gradual increases in systolic and mean pressures as the catheter position was moved proximally from the AVF anastomosis. Post hoc analysis after ANOVA revealed higher axillary artery systolic pressure compared to proximal brachial artery (153 vs 116.8, P = .007).

CONCLUSION

AVF-related steal syndrome decreases arterial inflow pressure of the affected extremity more proximally than previously thought. When performing a DRIL procedure, consideration should be given to placing the anastomosis as proximally as possible.

摘要

目的

动静脉内瘘（AVF）相关盗血后的治疗选择包括结扎、束带包扎和远端血管重建-节段性结扎（DRIL）。本研究的目的是评估上肢盗血综合征中的动脉压力梯度。

方法

对连续的患有手部缺血的AVF患者进行术前动脉造影和连续动脉内压力读数。采用重复测量方差分析（ANOVA）分析受试者间比较，事后分析确定流入压力最高的解剖位置。

结果

9例患者在AVF后出现手部缺血症状。回撤动脉压力测量显示，随着导管位置从AVF吻合口向近端移动，收缩压和平均压逐渐升高。方差分析后的事后分析显示，腋窝动脉收缩压高于肱动脉近端（153对116.8，P = 0.007）。

结论

AVF相关盗血综合征比之前认为的更靠近近端降低了患侧肢体的动脉流入压力。在进行DRIL手术时，应考虑尽可能在近端进行吻合。