Objective: Vascular steal syndrome of the distal extremity following Arterio-Venous (AV) fistula placement can occur in up to 2-20% of patients. This occurrence often leads to additional surgery such as the Distal Revascularization with Interval Ligation (DRIL) procedure, or fistula ligation. Although multiple risk factors have been shown to be associated with steal, there currently exists no reliable means by which to predict its development at the time of fistula creation. The purpose of this study was to apply a well-established perfusion measurement examination to the ipsilateral hand at the time of access in order to identify those patients at high risk for steal syndrome.
Results: In 29 consecutive controls with full data, the overall change in the hand perfusion ingress rate after AV fistula placement was 0.17 units/sec or 6%. None of these patients developed vascular steal.
Conclusions: Early data shows indocyanine green fluorescence angiography may be useful in predicting the development of vascular steal following AV fistula placement and the success of DRIL procedures.