Case 5

How do you treat steal syndrome?

There are multiple ways to treat steal syndrome. This patient underwent distal revascularization and interval ligation (DRIL) procedure. This is a surgical procedure, where the artery distal to the fistula (radial artery in this case) is ligated and a bypass graft is placed above the fistula. Patient’s ischemic hand symptoms dramatically improved within days after this procedure and his brachiocephalic fistula was able to be salvaged.