A Case of Simultaneous Operation for Unstable Angina and Leriche's Syndrome with a Large Arterial Collateral to the Lower Limb / 日本心臓血管外科学会雑誌

ABSTRACT

A 52-year-old male with unstable angina after acute myocardial infarction, and Leriche's syndrome was referred to our hospital for intensive care. He had a history of diabetes. Coronary angiography demonstrated a 75% stenosis of the LMT in association with a 90% stenosis of the LAD, 75% stenosis of the LCX and 99% stenosis of the RCA. Aortography revealed an arterial occlusion extending from the infrarenal aorta to both common iliac bifurcations. Both internal thoracic arteries were well developed as collateral pathways to external iliac arteries. With concomitant Y graft replacement of the abdominal aorta, two large internal thoracic arterial conduits and the right gastroepiploic artery were grafted to the coronary artery. This procedure was useful for protection of limb ischemia, in addition to producing a route for insertion of an intraaortic balloon pumping catheter.