Endovascular treatment of the culprit stenoses was accomplished after obtaining a confirmatory DSA. In 1 of 2 patients with symptoms of steal, the reported symptoms resolved postangioplasty [12]. MRA Extremity Area of Interest Without IV Contrast There is no identifiable relevant literature to support the use of MRA extremity without IV contrast in evaluation of suspected vascular steal. MRV Extremity Area of Interest Without and With IV Contrast There is no identifiable relevant literature to support the use of MRV extremity without and with IV contrast in evaluation of suspected vascular steal. MRV Extremity Area of Interest Without IV Contrast There is no identifiable relevant literature to support the use of MRV extremity without IV contrast in evaluation of suspected vascular steal. Variant 12: Suspected vascular steal syndrome (upper or lower extremity), suggested by cardiac failure or ischemic symptoms. Treatment and procedures. Fluoroscopy Fistulography Hemodialysis Access with Intervention While surgical management for vascular steal syndrome is often considered, fluoroscopic fistulography of the hemodialysis access with endovascular intervention may have a limited role in treatment, including elimination of a culprit arterial stenosis by angioplasty or stenting. In cases of DASS with stenosis of the inflow artery supplying the hemodialysis access and the extremity, endovascular angioplasty with or without stent placement has been proposed as a potential treatment [140]. Endovascular occlusion of hemodialysis access using vascular plugs has also been suggested as a potential treatment for patients with DASS as an alternative to surgical ligation [128]. In cases where surgical ligation may be challenging due to ulcerations or marked edema or swelling of the extremity, surgery may be delayed due to challenging patient comorbidities [128]. In such cases, an endovascular approach may be necessary to manage the problem.
Dialysis Fistula Malfunction. Endovascular treatment of the culprit stenoses was accomplished after obtaining a confirmatory DSA. In 1 of 2 patients with symptoms of steal, the reported symptoms resolved postangioplasty [12]. MRA Extremity Area of Interest Without IV Contrast There is no identifiable relevant literature to support the use of MRA extremity without IV contrast in evaluation of suspected vascular steal. MRV Extremity Area of Interest Without and With IV Contrast There is no identifiable relevant literature to support the use of MRV extremity without and with IV contrast in evaluation of suspected vascular steal. MRV Extremity Area of Interest Without IV Contrast There is no identifiable relevant literature to support the use of MRV extremity without IV contrast in evaluation of suspected vascular steal. Variant 12: Suspected vascular steal syndrome (upper or lower extremity), suggested by cardiac failure or ischemic symptoms. Treatment and procedures. Fluoroscopy Fistulography Hemodialysis Access with Intervention While surgical management for vascular steal syndrome is often considered, fluoroscopic fistulography of the hemodialysis access with endovascular intervention may have a limited role in treatment, including elimination of a culprit arterial stenosis by angioplasty or stenting. In cases of DASS with stenosis of the inflow artery supplying the hemodialysis access and the extremity, endovascular angioplasty with or without stent placement has been proposed as a potential treatment [140]. Endovascular occlusion of hemodialysis access using vascular plugs has also been suggested as a potential treatment for patients with DASS as an alternative to surgical ligation [128]. In cases where surgical ligation may be challenging due to ulcerations or marked edema or swelling of the extremity, surgery may be delayed due to challenging patient comorbidities [128]. In such cases, an endovascular approach may be necessary to manage the problem.