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Korean J Med > Volume 88(1); 2015 > Article
The Korean Journal of Medicine 2015;88(1): 83-88.
동정맥루 혈관성형술 후 발생한 피부괴사를 동반한 심한 도류증후군 1예
이영복1, 박하늘1, 김신영1, 김지은1, 최수진1, 원유동2, 김영옥1
1가톨릭대학교 의과대학 의정부성모병원 신장내과
2가톨릭대학교 의과대학 의정부성모병원 영상의학과
A Case of Severe Arterial Steal Syndrome with Skin Necrosis Developing after Percutaneous Angioplasty
Yeong Bok Lee1, Ha Neul Park1, Shin Young Kim1, Ji Eun Kim1, Su Jin Choi1, Yoo Dong Won2, Young Ok Kim1
1Departments of Nephrology, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
2Departments of Radiology, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
Corresponding Author: Young Ok Kim ,Tel: +82-31-820-3643, Fax: +82-31-847-2719, Email: cmckyo@catholic.ac.kr
Received: March 24, 2014;   Revised: April 13, 2014;   Accepted: May 16, 2014.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Arterial steal syndrome is a rare but serious complication that disrupts antegrade flow distal to an arteriovenous fistula (AVF) because of excess blood flow through the AVF. A 65-year-old woman with diabetes mellitus and undergoing hemodialysis was admitted for coldness and pain in the right hand ipsilateral to an AVF. AVF stenosis had developed 6 months after an upper-arm AVF operation. These manifestations developed 2 days after a successful radiological intervention for a stenotic lesion in the AVF, which became worse until the skin on her hand ulcerated. The symptoms became aggravated, particularly during dialysis. Fistulography revealed that the AVF anastomosis site was patent but blood flow toward the forearm had decreased severely. Arterial steal syndrome developing after percutaneous angioplasty for an AVF stenosis was suspected, and the AVF was ligated, which resolved the hand pain and ulceration.
Keywords: Angioplasty; Hemodialysis
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