Precision banding technique for arterial steal syndrome in a patient with chronic kidney disease on hemodialysis: A case report

Arriaga-Verastegui C.A.; Pintado-Guevara C.A.; Sarmiento-Falen J.; Vetanzo-Sánchez G.; Zavaleta-Corvera C. · Journal of Vascular Surgery Cases, Innovations and Techniques (2026) · DOI: 10.1016/j.jvscit.2026.102200

Resumen

Dialysis access-associated steal syndrome is an uncommon but potentially limb-threatening complication of high-flow arteriovenous fistulas (AVFs) in hemodialysis patients. We report a 48-year-old woman with progressive ischemic symptoms of the left hand secondary to a high-flow brachiocephalic AVF. Doppler ultrasound examination confirmed excessive access flow and severely reduced distal arterial perfusion. The patient underwent precision banding with continuous intraoperative Doppler guidance, allowing controlled flow reduction to a physiological range and immediate restoration of distal perfusion. Symptoms resolved completely, and AVF patency was preserved at the 1-year follow-up.

Instituciones: Universidad Científica del Sur; Universidad Privada Antenor Orrego