Download PDF
Semin intervent Radiol 2023; 40(03): 290-293
DOI: 10.1055/s-0043-1769765
Review Article

A Case of Ischemic Monomelic Neuropathy following Endovascular Arteriovenous Fistula Creation and Assisted Maturation

Kyle Sonnabend
1   Department of Radiology, University of Illinois Hospital and Health Sciences System, Chicago, Illinois
,
Simon Park
1   Department of Radiology, University of Illinois Hospital and Health Sciences System, Chicago, Illinois
,
Ketan Shah
2   Department of Interventional Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, Texas
,
Andrew J. Lipnik
1   Department of Radiology, University of Illinois Hospital and Health Sciences System, Chicago, Illinois
3   Division of Interventional Radiology, University of Illinois Hospital and Health Sciences System, Chicago, Illinois
,
Matthew M. Niemeyer
1   Department of Radiology, University of Illinois Hospital and Health Sciences System, Chicago, Illinois
3   Division of Interventional Radiology, University of Illinois Hospital and Health Sciences System, Chicago, Illinois
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Abstract

Dialysis access steal syndrome (DASS) is a phenomenon known to occur following creation of an arteriovenous fistula or arteriovenous graft. The clinical presentation of DASS is characterized by symptoms of limb ischemia due to diversion of arterial flow from the distal extremity. Ischemic monomelic neuropathy (IMN) is a rare subtype of DASS classically described as an acute, isolated presentation of peripheral neuropathy following dialysis access creation. Although the underlying pathophysiology is not entirely understood, the clinical manifestation of IMN is often described as severe distal limb pain that progresses to motor and sensory defects. The onset of IMN may occur immediately following dialysis access creation or intervention. Here, we present a case of IMN following assisted maturation of an endovascular fistula.

Keywords

ischemic monomelic neuropathy - dialysis access steal syndrome - arteriovenous fistula


Publication History

Article published online:
20 July 2023

© 2023. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Morsy AH, Kulbaski M, Chen C, Isiklar H, Lumsden AB. Incidence and characteristics of patients with hand ischemia after a hemodialysis access procedure. J Surg Res 1998; 74 (01) 8-10
    CrossrefPubMedGoogle Scholar
  • 2 Miles AM. Upper limb ischemia after vascular access surgery: differential diagnosis and management. Semin Dial 2000; 13 (05) 312-315
    CrossrefPubMedGoogle Scholar
  • 3 Scheltinga MR, van Hoek F, Bruijninckx CM. Time of onset in haemodialysis access-induced distal ischaemia (HAIDI) is related to the access type. Nephrol Dial Transplant 2009; 24 (10) 3198-3204
    CrossrefPubMedGoogle Scholar
  • 4 Wodicka R, Isaacs J. Ischemic monomelic neuropathy. J Hand Surg Am 2010; 35 (05) 842-843
    CrossrefPubMedGoogle Scholar
  • 5 Wilbourn AJ, Furlan AJ, Hulley W, Ruschhaupt W. Ischemic monomelic neuropathy. Neurology 1983; 33 (04) 447-451
    CrossrefPubMedGoogle Scholar
  • 6 Padberg Jr FT, Calligaro KD, Sidawy AN. Complications of arteriovenous hemodialysis access: recognition and management. J Vasc Surg 2008; 48 (5, Suppl): 55S-80S
    CrossrefPubMedGoogle Scholar
  • 7 DeCastro A, Keefe P. Wrist Drop. In: StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing; 2023. . PMID: 30422586
    Google Scholar
  • 8 Lane R, Nallamothu SV. Claw Hand. In: StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing; 2023. . PMID: 29939558
    Google Scholar
  • 9 Hye RJ, Wolf YG. Ischemic monomelic neuropathy: an under-recognized complication of hemodialysis access. Ann Vasc Surg 1994; 8 (06) 578-582
    CrossrefPubMedGoogle Scholar
  • 10 Riggs JE, Moss AH, Labosky DA, Liput JH, Morgan JJ, Gutmann L. Upper extremity ischemic monomelic neuropathy: a complication of vascular access procedures in uremic diabetic patients. Neurology 1989; 39 (07) 997-998
    CrossrefPubMedGoogle Scholar
  • 11 Leake AE, Winger DG, Leers SA, Gupta N, Dillavou ED. Management and outcomes of dialysis access-associated steal syndrome. J Vasc Surg 2015; 61 (03) 754-760
    CrossrefPubMedGoogle Scholar
  • 12 Lok CE, Huber TS, Lee T. et al; National Kidney Foundation. KDOQI clinical practice guideline for vascular access: 2019 update. Am J Kidney Dis 2020;75(4, Suppl 2):S1–S164 [Erratum in: Am J Kidney Dis 2021;7 7(4):551. PMID: 32778223]
    PubMedGoogle Scholar