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

Sonnabend, Kyle DO
Park, Simon MD
Shah, Ketan MD
Lipnik, Andrew J. MD
Niemeyer, Matthew M. MD

¹Department of Radiology, University of Illinois Hospital and Health Sciences System, Chicago, Illinois
²Department of Interventional Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, Texas
³Division of Interventional Radiology, University of Illinois Hospital and Health Sciences System, Chicago, Illinois

Address for correspondence Simon Park, MD, Department of Radiology, University of Illinois Hospital and Health Sciences System, UIH MC 931, 1740 W Taylor St., Chicago, IL 60612 (e-mail: [email protected])

Conflict of Interest

The authors have no conflicts of interest to declare.

Issue Theme Complications Issue of Seminars; Guest Editors, Matthew Niemeyer, MD and Ketan Shah, MD

Seminars in Interventional Radiology 40(3):p 290-293, June 2023. | DOI: 10.1055/s-0043-1769765

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.