Year: 2024
Type: article
Study design: Case Report
Abstract: Distal hypoperfusion ischemic syndrome (DHIS), also known as dialysis access steal syndrome (DASS), is a rare but significant complication in patients with end-stage renal disease (ESRD) undergoing hemodialysis through arteriovenous fistulas (AVFs). This case report presents a female patient in her 40s with a complex medical history, including peripheral arterial disease, coronary artery disease, and recurrent cellulitis affecting her right hand, who developed DHIS following the placement of a brachiobasilic AVF. Despite optimal medical management, the patient exhibited persistent ischemic symptoms, including hand coolness and necrosis, ultimately requiring surgical ligation of the AVF. Postoperatively, her symptoms significantly improved, highlighting the importance of early recognition and intervention in managing DHIS. This case demonstrates the need for a multidisciplinary approach involving nephrologists, vascular surgeons, and primary care providers to optimize patient outcomes and prevent severe complications. Furthermore, it emphasizes the necessity for standardized screening protocols for high-risk patients with AVFs, considering the psychosocial factors that can impact treatment adherence and long-term management.
Source: Cureus
DOI: 10.7759/cureus.74190
Authors: Vivie Tran, Diego Olavarria-Bernal, Ana Cordón, Judy Lalmuanpuii
Institution: Texas Tech University Health Sciences Center
Language: English
Subfield: Emergency Medical Services
Field: Health Professions
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4404620848