In nephrology, 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
Pallor
Diminished pulses (distal to the fistula)
Necrosis
Decreased wrist-brachial index (ratio of blood pressure measured in the wrist and the blood pressure measured in the upper arm), especially if below 0.6

Symptoms
Pain distal to the fistula.Symptoms are graded by their severity:
Grade 0: No symptoms of steal
Grade 1: Mild - cool extremity, improvement in hand pulse with access occlusion
Grade 2: Moderate - Ischemic symptoms during dialysis
Grade 3: Severe - Ischemic hand pain outside of dialysis; Ulcers or gangrene of the fingers

Diagnosis
History and physical exam - relief of symptoms with compression of the fistula on exam is highly suggestive of steal
Arteriography
Duplex ultrasound

Treatment
The fistula flow can be restricted through banding, or modulated through surgical revision. Revascularization techniques
Distal Revascularization and Interval Ligation (DRIL) procedure
PAI (Proximalization of the Arterial Inflow)
RUDI (Revision Using Distal Inflow)

Banding techniques
Narrowing suture
Plication
Minimally invasive MILLER banding
Tapering
Surgical bandingIf 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.
Angiofibroma (AGF) is a descriptive term for a wide range of benign skin or mucous membrane (i.e. the outer membrane lining body cavities such as the mouth and nose) lesions in which individuals have: 1) benign papules, i.e. pinhead-sized elevations that lack visible evidence of containing fluid; 2) nodules, i.e. small firm lumps usually >0.1 cm in diameter; and/or 3) tumors, i.e. masses often regarded as ~0.8 cm or larger. AGF  lesions share common macroscopic (i.e. gross) and microscopic appearances. Grossly, AGF lesions consist of multiple papules, one or more skin-colored to erythematous, dome-shaped nodules, or usually just a single tumor. Microscopically, they consist of spindle-shaped and stellate-shaped cells centered around dilated and thin-walled blood vessels in a background of coarse bundles of collagen (i.e. the main fibrous component of connective tissue). Angiofibromas have been divided into different types  but commonly a specific type was given multiple and very different names in different studies. The following list gives a brief description of the AFG types and their alternate names. Cutaneous angiofibroma: These papule, nodule, and/or tumor lesions occur on the: 1) face and are typically termed fibrous papules; 2) penis and are typically termed pearly penile papules; and 3) underneath a fingernail or toenail and are typically termed periungual angiofibromas. Some of these cutaneous AGF lesions occur in individuals with one or more of 3 different genetic diseases: tuberous sclerosis, multiple endocrine neoplasia type 1, and Birt-Hogg-Dube syndrome. The following are examples of these cutaneous angiofibromas and their alternate names.