JAAD grand round
JAAD Grand Rounds quiz∗: Hand ischemia in a hemodialysis patient

https://doi.org/10.1016/j.jaad.2012.01.048Get rights and content

Instructions: In answering each question, refer to the specific directions provided. Because it is often necessary to provide information occurring later in a series that give away answers to earlier questions, please answer the questions in each series in sequence.

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Discussion

Vascular steal syndrome is an uncommon complication of AVF formation that can lead to significant morbidity. It is caused by a significant decrease or reversal of flow in the arterial segment distal to the AVF or graft induced by the low resistance of the fistula outflow. While the steal effect occurs in 73% of patients after AVF construction, only 10% of cases become symptomatic. Patients with adequate collateral circulation and microvasculature are able to compensate for the steal effect;

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The authors, peer reviewer, and editor have no relevant financial relationships.

∗The section editor for JAAD Grand Rounds is Erin E. Boh, MD.

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