Revision using distal inflow (RUDI) may improve ischemic symptoms associated with dialysis access-associated steal syndrome (DASS) while preserving vascular access. The patient was a 68-year-old woman who had been undergoing hemodialysis for 4 months. Although vascular access was created at the patient’s elbow, left finger pain during dialysis appeared after the surgery. This symptom progressed to pain at rest. In addition, gangrene on the tips of thumb, middle finger, and little finger appeared 4 months later. RUDI was performed to diagnose DASS, and her symptoms improved thereafter.

A 72-year-old man had right common iliac artery aneurysm and we performed open surgery. We found the strong adhesion between right common iliac artery aneurysm and mesenterium, and the wall thickness, which we attributed to inflammatory common iliac artery aneurysm. We performed Y-grafting and histopathological diagnosis was IgG4 related periaortitis. Blood examination after the operation revealed no rise of IgG4 and an uneventful postoperative course was observed for six months without steroid therapy. The reports of inflammatory artery aneurysm due to IgG4 related periaortitis are few and there are some discussions about surgical method and steroid therapy. We present this case with literature review.