Vascular access steal syndrome is a syndrome caused by ischemia (not enough blood flow) resulting from a vascular access device (such as an arteriovenous fistula or synthetic vascular graft–AV fistula) that was installed to provide access for the inflow and outflow of blood during hemodialysis.

Signs

Symptoms

Symptoms are graded by their severity:

Diagnosis

Treatment

The fistula flow can be restricted through banding, or modulated through surgical revision.

Revascularization techniques

Banding techniques

If the above methods fail, the fistula is ligated, and a new fistula is created in a more proximal location in the same limb, or in the contralateral limb.

Incidence

DASS occurs in about 1% of AV fistulas and 2.7-8% of PTFE grafts.

Terminology

Within the contexts of nephrology and dialysis, vascular access steal syndrome is also less precisely just called steal syndrome (for short), but in wider contexts that term is ambiguous because it can refer to other steal syndromes, such as subclavian steal syndrome or coronary steal syndrome.