Subclavian Artery Angioplasty for Treatment of Coronary Artery 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.

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High-Risk Acute Coronary Syndrome in a Patient with Coronary Subclavian Steal Syndrome Secondary to Critical Subclavian Artery Stenosis

Case Reports in Cardiology ◽

10.1155/2014/175235 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

Zaher Fanari ◽

Niksad Abraham ◽

Sumaya Hammami ◽

Wasif A. Qureshi

Keyword(s):

Coronary Artery ◽

High Risk ◽

Cardiogenic Shock ◽

Subclavian Artery ◽

Left Ventricular ◽

Subclavian Steal Syndrome ◽

Coronary Syndrome ◽

Subclavian Steal ◽

Coronary Subclavian Steal Syndrome ◽

Steal Syndrome

Patients with multivessel coronary artery disease are more likely to have extensive atherosclerosis that involves other major arteries. Critical subclavian artery (SCA) stenosis can result in coronary subclavian steal syndrome that may present as recurrent ischemia and even myocardial infarction in patients with coronary artery bypass graft (CABG). In patients with concomitant severe native coronary disease, occluded saphenous venous grafts (SVG) to other arteries, percutaneous intervention on critical subclavian artery (SCA) stenosis that will compromise the blood flow to left internal mammary graft (LIMA) and left anterior descending (LAD) artery will be a high-risk procedure and may be associated with cardiogenic shock, especially in patients with preexisting ischemic cardiomyopathy. The use of percutaneous left ventricular (LV) assist device like Impella will offer better hemodynamic support and coronary perfusion and therefore results in decreased myocardial damage, maximized residual cardiac function, and lower incidence of cardiogenic shock.

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Coronary artery steal syndrome in patient after coronary arteries by-pass surgery and left subclavian artery stenting-is the maintenance of a patent internal mammary artery still necessary?

10.4172/interventional-cardiology.1000540 ◽

2016 ◽

Vol 08 (05) ◽

Author(s):

Rafal Januszek ◽

Artur Dziewierz ◽

Andrzej Brzychczy ◽

Marcin Misztal ◽

Dariusz Dudek

Keyword(s):

Coronary Artery ◽

Subclavian Artery ◽

Coronary Arteries ◽

Internal Mammary Artery ◽

Left Subclavian Artery ◽

Internal Mammary ◽

Steal Syndrome

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THINKING OUT OF THE BOX IN CARDIAC STEAL SYNDROME- LATE PRESENTATION OF A RARE CORONARY ARTERY FISTULOUS ANOMALY

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(21)04089-4 ◽

2021 ◽

Vol 77 (18) ◽

pp. 2734

Author(s):

Hasitha D. Manohar ◽

Kavel Patel ◽

Monarch Shah ◽

Eder Cativo Calderon

Keyword(s):

Coronary Artery ◽

Late Presentation ◽

Steal Syndrome

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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

Case Reports in Cardiology ◽

10.1155/2018/9340183 ◽

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.

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