Utilisation of Bicipital Aponeurosis for Banding to Treat the Dialysis Access Steal Syndrome (DASS) in High Flow Brachial-Cephalic Arterio-Venous Fistula: A Case Report

Przywara S, Ilzecki M, Terlecki P and Zubilewicz T

Department of Vascular Surgery and Angiology, Medical University of Lublin, Poland

^*Correspondance to: Stanislaw Przywara 

 PDF  Full Text DOI: 10.25107/2474-1647.1152

Abstract

We present a case of 36 years old male with end stage renal failure, hemodialysed for 3 years, who developed symptomatic Dialysis Access Steal Syndrome (DASS) in his right hand due to high flow brachial–cephalic arterio-venous fistula. Surgical treatment of steal syndrome was performed by aneurysmorrhaphy of draining cephalic vein, reinforced by the use of the part of bicipital aponeurosis as a native material for external banding. Intra-operative ultrasound showed immediate decrease of flow through the fistula, which dropped down from 2,6 L/min. to 900 mL/min. In postoperative period we observed complete recovery from upper limb ischemia symptoms. Patient received renal transplant 11 months later. During the follow up period, we did not observe any symptoms of DASS recurrence or infection and the fistula provided adequate hemodialysis. In selected patients, utilisation of bicipital aponeurosis as a native material for banding to treat DASS in high flow upper arm arterio-venous fistulas may be an alternative for PTFE (polytetrafluoroethylene) external cuff or PTFE graft axial interposition procedures.

Keywords

Cite the article

Przywara S, Ilzecki M, Terlecki P, Zubilewicz T. Utilisation of Bicipital Aponeurosis for Banding to Treat the Dialysis Access Steal Syndrome (DASS) in High Flow Brachial-Cephalic Arterio-Venous Fistula: A Case Report. Clin Surg. 2016; 1: 1152.