Vierhout Thomas, Saucedo-Crespo Hector, Auvenshine Christopher, Sakpal Sujit Vijay
Sanford School of Medicine, University of South Dakota, Sioux Falls, SD, USA.
Avera McKennan Hospital & University Health Center, Avera Medical Group Transplant & Liver Surgery, Sioux Falls, SD, USA.
SAGE Open Med Case Rep. 2022 Mar 15;10:2050313X221083513. doi: 10.1177/2050313X221083513. eCollection 2022.
Steal syndrome is a potential complication of surgically created arteriovenous fistulas that can result in sensory and/or motor deficits, or tissue loss in the affected limb. Several surgical techniques have been developed to treat steal syndrome, but all have potential drawbacks. We detail a novel, modified plication technique which involves sequential, longitudinal application of pledgets along the venous outflow to gradually narrow it, and consequently decrease flow. Its potential benefits include protection of the vein from bare suture, less turbulent flow, and thus lower risk of thrombosis. Implementation of this technique in two patients resulted in symptomatic relief and continuation of uninterrupted hemodialysis at 9- and 12-month follow-up, respectively.
窃血综合征是外科手术建立动静脉内瘘的一种潜在并发症，可导致患侧肢体感觉和/或运动功能障碍，或组织缺失。已经开发了几种外科技术来治疗窃血综合征，但都有潜在的缺点。我们详细介绍一种新颖的改良折叠技术，该技术包括沿着静脉流出道依次纵向应用棉垫以逐渐使其变窄，从而减少血流量。其潜在益处包括保护静脉免受裸缝扎影响、血流湍流减少，因而血栓形成风险降低。在两名患者中实施该技术分别在9个月和12个月的随访时症状缓解且能继续进行不间断血液透析。
