MANAGEMENT OF STEAL PHENOMENA DUE TO ARTERIOVENOUS HEMODIALYSIS FISTULA

Abstract

Renal failure occurs when the functioning renal mass is reduced sufficiently that the kidney is no longer able to carry out excretory function.

When conservative measures in acute or chronic renal failure produces no response then dialysis is the effective line of treatment.

Adequate hemodialysis requires blood flow of at least 200 ml/min., the most reliable long-term way of achieving this is surgical construction of arteriovenous fistula.

The most important feature of any form of vascular access is its length of survival as a functioning access. Requirements of a successful vascular access procedure for hemodialysis are a high blood flow (at least 200 ml/min), a diameter which is large enough to allow easy cannulation, a sufficient length to allow two needles to be inserted and facilitate the rotation of needle sites, its technical simplicity and quick operation under local anaesthetic, a low complication rate as regard to infection and thrombosis and a good long-term patency rate.

Primary arteriovenous fistulae remain the preferred method for long-term hemodialysis access. The radiocephalic fistula is the commonly performed fistula of choice, with a primary success rate of93% and a one-year patency rate reaching 82%.

Complications include thrombosis, infection, arterial steal Phenomena, venous hypertension, aneurysms, and congestive heart failure.Steal Phenomena distal to an