Successful Revision Using Distal Inflow for Dialysis-associated Steal Syndrome with Finger Gangrene

Abstract

Revision using distal inflow (RUDI) may improve ischemic symptoms associated with dialysis access-associated steal syndrome (DASS) while preserving vascular access. The patient was a 68-year-old woman who had been undergoing hemodialysis for 4 months. Although vascular access was created at the patient’s elbow, left finger pain during dialysis appeared after the surgery. This symptom progressed to pain at rest. In addition, gangrene on the tips of thumb, middle finger, and little finger appeared 4 months later. RUDI was performed to diagnose DASS, and her symptoms improved thereafter.