Publication:

Venous aneurysm development in left upper limb brachiocephalic arteriovenous fistula with manifestations of steal syndrome: a case report

Steal syndrome is a rare but significant complication of arteriovenous fistulas (AVF), characterized by distal limb ischemia due to blood diversion from the arterial circulation into the low-resistance venous side of the AVF. This phenomenon can lead to symptoms such as pain, pallor, and compromised tissue perfusion, requiring careful diagnosis and management. To describe the diagnosis, surgical management, and clinical outcome of a patient with a dysfunctional AVF due to steal syndrome in the context of hemodialysis (HD), emphasizing the importance of early diagnosis and surgical planning to prevent complications such as distal ischemia and access dysfunction. A 42-year-old female with a longstanding history of end-stage renal disease (ESRD) and HD presented with a progressively enlarging, painful left brachiocephalic AVF. She exhibited symptoms of steal syndrome, including palpitations and tachycardia during dialysis. Diagnostic imaging revealed a dysfunctional AVF with a venous aneurysm, necessitating surgical intervention for correction.