Use of angioplasty in the prevention and treatment of coronary--subclavian steal syndrome.

Abstract

PURPOSE:

The coronary-subclavian artery steal (CSS) syndrome is caused by critical stenosis in the subclavian artery proximal to a bypass graft from the internal mammary artery (IMA) to the coronary artery. The stenosis results in retrograde flow in the IMA and steal from the coronary artery.

PATIENTS AND METHODS:

Percutaneous transluminal angioplasty (PTA) was performed in eight patients (five men, three women). In four patients (group 1), coronary ischemia had developed 0.5-70 months (mean, 31 months) after IMA-to-coronary artery bypass surgery. These four patients (mean age, 58 years; range, 44-68 years) underwent PTA of a single area of focal subclavian stenosis to treat CSS. In four other patients (group 2), atherosclerotic subclavian stenosis had developed proximal to a donor IMA before planned bypass surgery. These patients (mean age, 53 years; range, 50-57 years) underwent PTA of a single focal subclavian stenosis to prevent CSS.

RESULTS:

Group 1 patients were free of myocardial ischemia at follow-up (mean follow-up, 39.0 months; range, 14-101 months). Three of four patients in group 2 underwent coronary artery bypass grafting with the ipsilateral IMA following PTA of the subclavian stenosis; they were free of angina at follow-up (mean follow-up, 14 months; range, 10-18 months).

CONCLUSION:

PTA is a safe and efficacious short-term method for prevention and treatment of CSS syndrome.

• Authors: M J Hallisey, J H Rees, S G Meranze, A Siegfeld, R Lowe
• Journal: Journal of vascular and interventional radiology : JVIR (J Vasc Interv Radiol) 1995 Jan-Feb Vol. 6 Issue 1 Pg. 125-9 ISSN: 1051-0443 [Print] United States
• PMID: 7703577 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Angina Pectoris (prevention & control, therapy)
• Angioplasty, Balloon
• Arteriosclerosis (etiology, prevention & control, therapy)
• Coronary Artery Bypass
• Coronary Disease (etiology, prevention & control, therapy)
• Female
• Follow-Up Studies
• Humans
• Internal Mammary-Coronary Artery Anastomosis (adverse effects)
• Male
• Middle Aged
• Myocardial Ischemia (etiology, prevention & control, therapy)
• Subclavian Artery
• Subclavian Steal Syndrome (etiology, prevention & control, therapy)