scholarly journals Coronary Subclavian Steal Syndrome Unamenable to Angioplasty Successfully Managed with Subclavian-Subclavian Bypass

2012 ◽  
Vol 2012 ◽  
pp. 1-4
Author(s):  
Saad Tariq ◽  
Swosty Tuladhar ◽  
Edward Wingfield ◽  
Honesto Poblete
Keyword(s):  
Carotid Artery ◽  
Internal Mammary Artery ◽  
Carotid Artery Disease ◽  
Left Internal Mammary Artery ◽  
Subclavian Steal Syndrome ◽  
Subclavian Steal ◽  
Bilateral Carotid ◽  
Internal Mammary ◽  
Coronary Subclavian Steal Syndrome ◽  
Steal Syndrome

Purpose. Coronary-subclavian steal syndrome (CSSS) is defined as a reversal of flow in a previously constructed internal mammary artery (IMA) coronary conduit, producing myocardial ischemia. We present a case of CSSS which could not be ameliorated with endovascular therapy and necessitated a subclavian-subclavian bypass.Case Report. 80-year-old Caucasian male with history of CABG presented with syncope. He had absent left-sided radial pulse with blood pressure being 60/40 on left arm and 130/80 on the right. He underwent cardiac catheterization for NSTEMI which showed patent left internal mammary artery graft to left anterior descending coronary artery with retrograde flow, and diagnosis of coronary subclavian steal syndrome was made. Complete occlusion of proximal left subclavian artery was identified. Percutaneous angioplasty failed because of calcified plaque causing 100% occlusion. Carotid doppler showed bilateral carotid artery disease. He finally underwent subclavian-subclavian bypass which resolved his condition.Conclusion. Subclavian-subclavian bypass is a successful alternative to carotid-subclavian bypass for management of CSSS especially with concomitant critical carotid artery atherosclerotic disease.

scholarly journals Treatment of an Unusual Occurrence of a Complex Left Subclavian Artery/Left Internal Mammary Artery Bifurcation Stenosis in the Setting of Coronary Subclavian Steal Syndrome and Ischemic Left Ventricular Systolic Dysfunction

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Michael J. Martinelli ◽  
Michael B. Martinelli
Keyword(s):  
Subclavian Artery ◽  
Internal Mammary Artery ◽  
Left Subclavian Artery ◽  
Left Internal Mammary Artery ◽  
Systolic Dysfunction ◽  
Left Ventricular ◽  
Subclavian Steal Syndrome ◽  
Internal Mammary ◽  
Coronary Subclavian Steal Syndrome ◽  
Steal Syndrome

This case will illustrate the clinical and unique technical challenges, not previously reported, in a patient with a history of progressive left ventricular (LV) systolic dysfunction, congestive heart failure (CHF), myocardial infarction (MI), and a complex bifurcation lesion of the left subclavian artery (SA) involving the left internal mammary artery (LIMA) in the setting of coronary subclavian steal syndrome (CSSS). The approach to this lesion is complicated by significant LIMA involvement requiring intervention directed toward both the SA and the LIMA in the presence of severe LV systolic dysfunction. This clinical scenario necessitates a careful technique, utilizing bifurcation methods similar to those used in coronary intervention.

Coronary Subclavian Steal Syndrome: A Contemporary Review

Cardiology ◽  
2020 ◽  
Vol 145 (9) ◽  
pp. 601-607
Author(s):  
Hassan M. Lak ◽  
Rohan Shah ◽  
Beni Rai Verma ◽  
Eric Roselli ◽  
Francis Caputo ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Subclavian Artery ◽  
Left Internal Mammary Artery ◽  
Artery Bypass ◽  
Subclavian Steal Syndrome ◽  
Subclavian Steal ◽  
Internal Mammary ◽  
Coronary Subclavian Steal Syndrome ◽  
The Cost ◽  
Steal Syndrome

Coronary subclavian steal syndrome (CSSS) is a rare cause of angina. It occurs in patients with prior coronary artery bypass grafting and, specifically, a left internal mammary artery (LIMA) to left anterior descending artery (LAD) graft and co-existent significant subclavian artery stenosis. In this context, there is retrograde blood flow through the LIMA to LAD graft to supply the subclavian artery beyond the significant stenosis. This potentially occurs at the cost of compromising coronary artery perfusion dependent on the LIMA graft. In this review, we present a case of a middle-aged female who suffered from CSSS and review the literature for the contemporary diagnosis and management of this condition.

scholarly journals Coronary-Subclavian Steal Syndrome: Percutaneous Approach

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Carina Machado ◽  
Luís Raposo ◽  
Sílvio Leal ◽  
Pedro Araújo Gonçalves ◽  
Henrique Mesquita Gabriel ◽  
...  
Keyword(s):  
Subclavian Artery ◽  
Previous History ◽  
Myocardial Revascularization ◽  
Coronary Bypass ◽  
Subclavian Steal Syndrome ◽  
Subclavian Steal ◽  
Artery Graft ◽  
Internal Mammary ◽  
Coronary Subclavian Steal Syndrome ◽  
Steal Syndrome

Coronary subclavian steal syndrome is a rare ischemic cause in patients after myocardial revascularization surgery. Subclavian artery stenosis or compression proximal to the internal mammary artery graft is the underlying cause. The authors present a clinical case of a patient with previous history of non-ST elevation myocardial infarction, triple coronary bypass, and effort angina since the surgery, with a positive ischemic test. Coronary angiography revealed a significant stenosis of the left subclavian artery, proximal to the internal mammary graft.

scholarly journals Coronary Subclavian Steal Syndrome: An Unusual Cause of Angina in a Post-CABG Patient

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Usman Younus ◽  
Brandon Abbott ◽  
Deepika Narasimha ◽  
Brian J. Page
Keyword(s):  
Chest Pain ◽  
Coronary Artery ◽  
Left Internal Mammary Artery ◽  
Rare Complication ◽  
Artery Bypass ◽  
Subclavian Steal Syndrome ◽  
Subclavian Steal ◽  
Nuclear Stress Testing ◽  
Coronary Subclavian Steal Syndrome ◽  
Steal Syndrome

Coronary subclavian steal syndrome is a rare complication of coronary artery bypass grafting surgery (CABG) when a left internal mammary artery (LIMA) graft is utilized. This syndrome is characterized by retrograde flow from the LIMA to the left subclavian artery (SA) when a proximal left SA stenosis is present. We describe a unique case of an elderly male who underwent CABG 6 years ago who presented with prolonged chest pain, mildly elevated troponins, and unequal pulses in his arms. A CTA of the chest demonstrated a severely calcified occluded proximal left SA jeopardizing his LIMA graft. Subclavian angiography was performed with an attempt to revascularize the patient’s occluded left SA which was unsuccessful. We referred the patient for nuclear stress testing which demonstrated a moderate size area of anterior ischemia on imaging; the patient exercised to a fair exercise capacity of 7 METS with no chest pain and no ECG changes. Subsequent coronary angiography showed severe native three-vessel coronary artery disease with intermittent retrograde blood flow from the LIMA to the left SA distal to the occlusion, jeopardizing perfusion to the left anterior descending (LAD) coronary artery distribution. He declined further options for revascularization and was discharged with medical management.

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