Steal syndrome complicating upper extremity hemoaccess procedures: incidence and risk factors

Article Figures & Tables

Table 1

Characteristics of 325 Upper Extremity Hemoaccess Procedures

Characteristics	No. (and %) of procedures^*
Mean (and range) age at procedure, yr	66.0 (18–86)

Men	171 (52.6)

Women	154 (47.4)

Race
Caucasian	234 (72.0)

Aboriginal	40 (12.3)

Other	51 (15.7)

Diabetes mellitus	164 (50.5)

Hypertension	271 (83.4)

CAD or CVD	187 (57.5)

Smoking
Yes	52 (16.0)

No or quit	219 (67.4)

Unknown	54 (16.6)

Proximal procedures (brachial artery)	230 (70.8)

Distal procedures (radial artery)	95 (29.2)

Polytetrafluoroethylene grafts	163 (50.2)

Autologous fistulas	162 (49.8)

Table 2

Characteristics of 20 Cases of Steal Syndrome

Characteristics	No. (and %) of cases^*
Median (and range) age at procedure, yr	67.5 (55–82)

Men	7 (35)

Women	13 (65)

Race
Caucasian	12 (60)

Aboriginal	5 (25)

Other	3 (15)

Diabetes	18 (90)

Hypertension	18 (90)

CAD or CVD	14 (70)

Smoking
Yes	2 (10)

No or quit	13 (65)

Unknown	5 (25)

Proximal procedures (brachial artery)	19 (95)

Distal procedures (radial artery)	1 (5)

Polytetrafluoroethylene grafts	15 (75)

Autologous fistulas	5 (25)

Treatment
Ligation	10 (50)

Removal	4 (20)

Banding	2 (10)

Conservative	4 (20)

Table 3

Univariate Analysis of Suggested Risk Factors for Steal

Risk factor	Odds ratio	95% confidence interval	p value
Diabetes mellitus	6.04	1.74–21.01	0.005
Polytetrafluoroethylene graft	3.16	1.12–8.91	0.03
Female sex	2.77	1.04–7.39	0.04
Proximal procedure	8.42	1.11–63.84	0.04
CAD or CVD	2.70	1.02–7.08	0.05
Aboriginal race	2.58	0.88–7.54	0.08
Age	1.03	0.99–1.06	0.10
Smoking	0.57	0.13–2.53	0.46
Hypertension	1.16	0.33–4.10	0.82

Table 4

Multivariate Stepwise Logistic Regression Analysis of Suggested Risk Factors for Steal

Risk factor	Odds ratio	95% confidence interval	p value
Diabetes mellitus	5.00	1.39–18.08	0.01
Aboriginal race	3.59	1.07–12.04	0.04
Age	1.04	1.00–1.09	0.07
Proximal procedure	6.28	0.79–49.90	0.08
Female sex	2.21	0.79–6.18	0.13