ABSTRACT
A fifty-two-year-old woman with angina pectoris due to coronary-subclavian steal syndrome through a left internal mammary artery graft placed distal to a left anterior descending artery stenosis is presented. Retrograde flow through the mammary artery graft due to severe left subclavian stenosis was observed angiographically. Accordingly, left subclavian balloon angioplasty was performed, restoring normal antegrade flow through the internal mammary artery graft and resulting in resolution of the patient's symptoms. The patient was subsequently discharged with no evidence of angina. Carotid-subclavian bypass surgery was avoided, reducing patient discomfort, procedural risk, and expense.
Subject(s)
Angina Pectoris/etiology , Angina Pectoris/therapy , Angioplasty, Balloon , Internal Mammary-Coronary Artery Anastomosis , Postoperative Complications/therapy , Subclavian Steal Syndrome/etiology , Subclavian Steal Syndrome/therapy , Constriction, Pathologic/etiology , Constriction, Pathologic/therapy , Female , Humans , Middle Aged , Subclavian ArteryABSTRACT
Coronary stent placement is one of the newest treatments for occlusion of the coronary arteries. This technique has the potential to minimize restenosis and reduce or eliminate abrupt closure, common complications of percutaneous transluminal coronary angioplasty (PTCA). Initial studies in Europe in the mid-1980s indicated a problem with restenosis due to thrombosis and intimal hyperplasia in stented arteries. Recent investigational studies of the Palmaz balloon-expandable stent in the United States, however, show great promise in solving those problems. It is hoped that coronary stenting may be used for lesions now treated by coronary artery bypass graft surgery, as well as for improving the outcome of PTCA.
