1. Arterial Steal Syndrome: A Modest Proposal for an Old Paradigm
Arif Asif, MD, Carlos Leon, MD, Donna Merrill, RN, Bhagwan Bhimani, MD, Renee Ellis, MD, Marco Ladino, MD, Florin N. Gadalean, MD 
American Journal of Kidney Diseases 
Volume 48, Issue 1, Pages (July 2006)
DOI: /j.ajkd
Copyright © 2006 National Kidney Foundation, Inc. Terms and Conditions

2. Fig 1
Results of arteriography in 12 consecutive patients undergoing arteriography. *Two patients with arterial stenosis were referred for surgical intervention.
American Journal of Kidney Diseases  , 88-97DOI: ( /j.ajkd )
Copyright © 2006 National Kidney Foundation, Inc. Terms and Conditions

3. Fig 2
(A) An axillary artery stenosis (70%). (B) Successful dilatation of the stenotic lesion after balloon angioplasty with resolution of symptoms of steal syndrome.
American Journal of Kidney Diseases  , 88-97DOI: ( /j.ajkd )
Copyright © 2006 National Kidney Foundation, Inc. Terms and Conditions

4. Fig 3
Brachiocephalic fistula with (A) critical stenosis of the brachial artery in the anastomotic area and (B) successful angioplasty of the lesion.
American Journal of Kidney Diseases  , 88-97DOI: ( /j.ajkd )
Copyright © 2006 National Kidney Foundation, Inc. Terms and Conditions

5. Fig 4
(A) A patient with a brachial artery (arrow) to cephalic vein fistula with symptoms of arterial steal. Retrograde flow into the fistula was seen through the distal portion of the brachial artery. No flow distally past the arrowhead was seen on angiography. (B, C) Upon occlusion, antegrade flow was established into the forearm arteries (arrows).
American Journal of Kidney Diseases  , 88-97DOI: ( /j.ajkd )
Copyright © 2006 National Kidney Foundation, Inc. Terms and Conditions

6. Fig 5
(A-F) Arteriography in a patient with symptoms of arterial steal syndrome. Arrows indicate the direction of blood flow. Bold arrow (short) indicates 60% stenosis of the artery just proximal to the anastomosis. Bold arrow (long) shows a juxta-anastomotic venous stenosis. Even this stenosis was not able to protect the patient against steal syndrome. Retrograde flow was noted through the radial artery into the access. Physical examination could confirm the retrograde filling of the radial artery by occluding the ulnar artery and performing palpation of the radial artery. The patient showed a good radial artery on physical examination. This case required an axillary loop fistula using the outflow of the existing fistula. Abbreviations: RA, radial artery; UA, ulnar artery; CVAVF, cephalic vein arteriovenous fistula.
American Journal of Kidney Diseases  , 88-97DOI: ( /j.ajkd )
Copyright © 2006 National Kidney Foundation, Inc. Terms and Conditions

7. Fig 6
A simple algorithm to manage patients with symptoms of arterial steal.
American Journal of Kidney Diseases  , 88-97DOI: ( /j.ajkd )
Copyright © 2006 National Kidney Foundation, Inc. Terms and Conditions

8. Fig 7
A patient with a radiocephalic fistula. (A) Arrows indicate vascular calcification of forearm arteries. (B) The brachial artery of the same patient also shows calcification. Anastomosis (double arrow), imaging catheter into the fistula (arrowhead).
American Journal of Kidney Diseases  , 88-97DOI: ( /j.ajkd )
Copyright © 2006 National Kidney Foundation, Inc. Terms and Conditions