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首页> 外文期刊>Current Surgery >Ischemic steal syndrome: a case series and review of current management.
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Ischemic steal syndrome: a case series and review of current management.

机译：缺血性盗窃综合征：一个病例系列和当前治疗的回顾。

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BACKGROUND: Currently over 5000 patients are receiving hemodialysis in Australia, which is an increase by approximately 7% each year. Distal ischemia secondary to the steal syndrome (ISS) is an uncommon but recognized complication. Several methods are now available to manage this problem including ligation, banding, and distal revascularization with interval ligation (DRIL). The aim of this report is to review the experience of the authors on this complication and its management at Royal Perth Hospital. METHODS: The Vascular Physiology Laboratory Database was used to identify those patients referred for investigation of ISS. Data were collected retrospectively from these patients' files concerning their demographics, graft particulars, and type of interventional procedure. Patients were then recalled to assess long-term patency and current venous access and for postoperative vascular studies. RESULTS: Eighteen people were identified with ischemic symptoms. The mean age was 66 (range, 44 to 82). Fourteen (77.8%) were men, and 15 (83.3%) were diabetic. Renal failure was secondary to diabetes in 8 patients, hypertension in 3, and a combination of both in 7 patients. Intervention was via the DRIL procedure in 12, ligation in 5, and banding in 1. One patient underwent angioplasty of the ulnar artery before DRIL. At follow-up (between 1 and 12 months), all DRIL bypass were patents. The 5 ligated patients all improved, and the patient who underwent banding thrombosed their graft. CONCLUSION: The DRIL procedure should be considered the standard operation to manage ISS in that it manages the ischemia while maintaining the functional fistula. It is, however, still necessary to ligate some fistulae and seek alternative access. There are still no preoperative indicators as to who will suffer ISS.
机译：背景：目前澳大利亚有超过5000名患者正在接受血液透析，并且每年以大约7％的速度增长。继发于盗窃综合征（ISS）的远端缺血是一种罕见但公认的并发症。现在有几种方法可以解决该问题，包括结扎，绑扎和间隔结扎术（DRIL）进行远端血运重建。本报告的目的是回顾作者在皇家珀斯医院进行的并发症及其处理的经验。方法：使用血管生理实验室数据库来识别转诊进行ISS的患者。回顾性地从这些患者的档案中收集有关其人口统计学，移植物详情和介入手术类型的数据。然后召回患者以评估长期通畅性和当前静脉通路，并进行术后血管研究。结果：确定有18人患有缺血性症状。平均年龄为66岁（范围为44至82）。男性为14位（77.8％），糖尿病为15位（83.3％）。肾衰竭是继发于糖尿病的8例患者，高血压继发的3例，以及两者合并的7例。干预通过DRIL程序进行，第12步进行结扎，第5步进行结扎，在1项中进行绑扎。一名患者在DRIL之前接受了尺动脉血管成形术。在随访中（1到12个月之间），所有DRIL旁路均已获得专利。 5例结扎患者全部好转，接受绑扎术的患者血栓形成了他们的移植物。结论：DRIL程序应被视为管理ISS的标准操作，因为它可以在维持功能性瘘管的同时管理缺血。但是，仍然有必要结扎一些瘘管并寻求其他途径。尚无关于谁将遭受ISS的术前指标。

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