Subclavian artery stenosis or occlusion may be a cause of myocardial ischemia in patients treated using an internal mammary artery graft. Subclavian stenosis may cause myocardial ischemia during arm exercise by a coronary-subclavian steal phenomenon, with flow inversion in the graft from the coronary tree to the left subclavian artery. We here describe a case of a patient developing left subclavian occlusion after coronary artery bypass grafting with the left internal mammary artery. The lesion was successfully treated with a carotid-subclavian bypass. The article underscores the importance of an early diagnosis (possibly before bypass surgery) and discusses possible treatments. Percutaneous interventions with stent implantation appear the treatment of choice, but surgery has an important role in case of total occlusion.

A uncommon cause of angina during upper limb exercise / Speciale, Giulio; Pristipino, Christian; Pasceri, Vincenzo; Irini, Diego; Pelliccia, Francesco; Granatelli, Antonino; Pironi, Bruno; Roncella, Adriana; Richichi, Giuseppe. - In: ITALIAN HEART JOURNAL. - ISSN 1129-471X. - STAMPA. - 5:7(2004), p. 548-50.

A uncommon cause of angina during upper limb exercise

PELLICCIA, FRANCESCO;
2004

Abstract

Subclavian artery stenosis or occlusion may be a cause of myocardial ischemia in patients treated using an internal mammary artery graft. Subclavian stenosis may cause myocardial ischemia during arm exercise by a coronary-subclavian steal phenomenon, with flow inversion in the graft from the coronary tree to the left subclavian artery. We here describe a case of a patient developing left subclavian occlusion after coronary artery bypass grafting with the left internal mammary artery. The lesion was successfully treated with a carotid-subclavian bypass. The article underscores the importance of an early diagnosis (possibly before bypass surgery) and discusses possible treatments. Percutaneous interventions with stent implantation appear the treatment of choice, but surgery has an important role in case of total occlusion.
2004
Angina Pectoris; Coronary Angiography; Coronary Artery Bypass; Coronary Disease; Exercise; Female; Follow-Up Studies; Humans; Internal Mammary-Coronary Artery Anastomosis; Middle Aged; Reoperation; Risk Assessment; Subclavian Steal Syndrome; Treatment Outcome; Vascular Surgical Procedures
01 Pubblicazione su rivista::01a Articolo in rivista
A uncommon cause of angina during upper limb exercise / Speciale, Giulio; Pristipino, Christian; Pasceri, Vincenzo; Irini, Diego; Pelliccia, Francesco; Granatelli, Antonino; Pironi, Bruno; Roncella, Adriana; Richichi, Giuseppe. - In: ITALIAN HEART JOURNAL. - ISSN 1129-471X. - STAMPA. - 5:7(2004), p. 548-50.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/896993
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