Abstract | OBJECTIVES: This study addresses the efficacy of directional atherectomy in the subclavian artery for the relief of angina in patients with the coronary-subclavian steal syndrome. In addition, we review the histologic findings from the atherectomy specimens. BACKGROUND: METHODS: RESULTS: All three patients had immediate symptomatic relief after the atherectomy, and postprocedure exercise testing demonstrated improved cardiac function. Two patients remain asymptomatic at 7 and 8 months, respectively; the third patient developed unstable angina 9 months later because of severe restenosis that was again successfully treated with atherectomy. Histologic examination of the specimens revealed atherosclerotic plaque, occasionally with adventitia. The specimen from the repeat atherectomy showed severe intimal hyperplasia. CONCLUSIONS: Directional atherectomy appears to be a safe and effective treatment for coronary-subclavian steal syndrome. This procedure may be the treatment of choice for patients in whom a vascular bypass operation is not feasible.
|
Authors | J A Breall, W Grossman, I E Stillman, L E Gianturco, D Kim |
Journal | Journal of the American College of Cardiology
(J Am Coll Cardiol)
Vol. 21
Issue 7
Pg. 1564-7
(Jun 1993)
ISSN: 0735-1097 [Print] United States |
PMID | 8496520
(Publication Type: Case Reports, Journal Article, Research Support, U.S. Gov't, P.H.S.)
|
Topics |
- Adult
- Aged
- Angina Pectoris
(etiology, surgery)
- Atherectomy
- Coronary Disease
(surgery)
- Female
- Humans
- Internal Mammary-Coronary Artery Anastomosis
- Male
- Middle Aged
- Postoperative Complications
(surgery)
- Subclavian Artery
(surgery)
- Subclavian Steal Syndrome
(surgery)
|