title: Dialysis arteriovenous fistula causing subclavian steal syndrome in the absence of subclavian artery stenosis.
abstract: We present a rare cause of subclavian steal syndrome secondary to a dialysis arteriovenous fistula (AVF). A 69-year-old female with end-stage renal disease presented with ataxia and recurrent fainting spells. Angiography revealed normal subclavian arteries bilaterally, a right VA origin occlusion, and an apparent left VA origin occlusion. However, carotid artery angiography demonstrated flow through the posterior communicating artery with retrograde filling of the basilar artery and left VA to its subclavian origin. Repeat left subclavian arteriography during external compression of the AVF demonstrated normal antegrade left VA flow. The AVF was subsequently ligated resulting in complete symptom resolution.
authors.affiliation: Department of Neurological Surgery, University of Miami School of Medicine, Miami, FL 33136, USA.
authors.forename: Eesha
authors.initials: E
authors.lastname: Maiodna
authors.affiliation: Department of Neurological Surgery, University of Miami School of Medicine, Miami, FL 33136, USA.
authors.forename: Sudheer
authors.initials: S
authors.lastname: Ambekar
authors.affiliation: Department of Neurological Surgery, University of Miami School of Medicine, Miami, FL 33136, USA.
authors.forename: Jeremiah N
authors.initials: JN
authors.lastname: Johnson
authors.affiliation: Department of Neurological Surgery, University of Miami School of Medicine, Miami, FL 33136, USA.
authors.forename: Mohamed Samy
authors.initials: MS
authors.lastname: Elhammady