Tratamento cirúrgico da

Fábio Linardi; Felipe de Francisco Linardi; José Luis Bevilacqua; José Francisco Moron Morad; José Augusto Costa

doi:10.1590/S1677-54492006000200007

Original Article

Tratamento cirúrgico da "síndrome do roubo" em acesso vascular para hemodiálise com revascularização distal e ligadura arterial

Surgical treatment of "steal syndrome" at hemodialysis vascular access with revascularization and distal artery ligation

Fábio Linardi; Felipe de Francisco Linardi; José Luis Bevilacqua; José Francisco Moron Morad; José Augusto Costa

http://dx.doi.org/10.1590/S1677-54492006000200007 J Vasc Bras, vol.5, n2, p.117-122, 2006

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Resumo

OBJETIVO: O propósito do trabalho é apresentar o resultado do tratamento da "síndrome do roubo", sintomática em acesso vascular para hemodiálise, utilizando a técnica da revascularização distal com ligadura arterial. PACIENTES E MÉTODOS: No período de dezembro de 2003 a novembro de 2004, quatro pacientes que apresentaram síndrome do roubo sintomática em acesso vascular para hemodiálise foram submetidos à revascularização distal com ligadura arterial e acompanhados até dezembro de 2005. Os quatro pacientes apresentavam dor de repouso, e dois casos evoluíram para lesão trófica. RESULTADOS: Todos os casos apresentaram regressão dos sintomas, com cicatrização das lesões tróficas e manutenção do acesso vascular, que continuou sendo utilizado para realização de sessões de hemodiálise. CONCLUSÕES: Concluímos que, atualmente, o tratamento de escolha da síndrome do roubo sintomática é a revascularização distal com ligadura arterial, pois, além de tratar a isquemia do membro, mantém o acesso vascular funcionante.

Palavras-chave

Acesso vascular, síndrome do roubo, hemodiálise, fístula arteriovenosa

Abstract

OBJECTIVE: The authors report results for the surgical treatment of ischemic "steal syndrome" resulting from hemodialysis vascular access with distal revascularization-interval ligation procedure. METHODS: From December 2003 through November 2004, four patients with "steal syndrome" resulting from hemodialysis vascular access were submitted to distal revascularization-interval ligation and followed until December 2005. All four patients had rest pain and two developed ulcerations. RESULTS: All patients presented regression of symptoms, healing of ulcerations, and continued to use the same vascular access for hemodialysis. CONCLUSION: The authors conclude that the distal revascularization-interval ligation procedure is the treatment of choice for ischemic "steal syndrome", since it effectively treats the ischemic symptoms and maintains a functioning vascular access.

Keywords

Vascular access, steal syndrome, hemodialysis, arteriovenous fistula

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