Abstract Vascular access steal syndrome (VASS) represents a significant complication following arteriovenous fistula (AVF) creation for hemodialysis, occurring in approximately 1%–8% of cases. We present the case of a 35-year-old female with chronic kidney disease Stage 5 and hypertension who developed severe VASS within 6 days of brachial–cubital AVF creation. The patient presented with classic symptoms including limb heaviness, acralcyanosis, and hand weakness, complicated by pulmonary edema. Doppler ultrasonography revealed a high-flow fistula (1800 mL/min) with compromised distal perfusion. Emergency surgical intervention with fistula takedown was performed, resulting in complete resolution of symptoms. This case emphasizes the importance of early recognition of VASS, particularly in patients with multiple comorbidities, and demonstrates that prompt surgical intervention can lead to excellent outcomes.
Shahnawaz Bashir (Tue,) studied this question.
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