The Useful Application of Indocyanine Green Angiography to Evaluate the Outcome for Distal Revascularization-Interval Ligation in a Patient with Dialysis-Associated Steal Syndrome

Abstract

Distal revascularization-interval ligation (DRIL) for dialysis access-associated steal syndrome (DASS) may be performed to improve ischemic symptoms while preserving the vascular access. We herein report a case in which the outcome of DRIL was evaluated with indocyanine green angiography (ICGA). The case was a 75-year-old male. Even though a vascular access was created at the patient's elbow, left finger pain during dialysis appeared after the surgery. In addition, gangrene of the left middle finger tip appeared 12 months later. DRIL was performed in the diagnosis of DASS and his symptoms thereafter improved. Based on the findings of ICGA, it was noted that the time elapsed from ICG onset to half the maximum intensity improved from 56.6 seconds to 48.4 seconds. ICGA may therefore be a useful modality to evaluate ischemia of upper limb extremities.