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Published on: September 13, 2020

Percutaneous treatment of coronary subclavian steal syndrome

Niall T Mulvihill1, Mohamed Loutfi, Emmanuel Salengro

  • 1Unite de Cardiologie Interventionelle, Clinique Pasteur, Toulouse, France. mulvihn@tcd.ie

The Journal of Invasive Cardiology
|July 4, 2003
PubMed

Insights

Coronary subclavian steal syndrome, a complication of internal mammary artery grafts, causes coronary ischemia due to subclavian artery stenosis. Percutaneous treatment offers excellent immediate and long-term results for this condition.

Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology
  • Vascular Surgery

Background:

  • Coronary subclavian steal syndrome (CSSS) is a rare complication following coronary artery bypass grafting (CABG) using internal mammary artery (IMA) grafts.
  • It is characterized by reversed flow in the IMA graft due to proximal subclavian artery stenosis, leading to myocardial ischemia.

Purpose of the Study:

  • To describe the pathophysiology and clinical presentation of CSSS.
  • To evaluate the efficacy and safety of percutaneous intervention for treating CSSS.

Main Methods:

  • Review of relevant literature and case studies.
  • Analysis of percutaneous techniques, including angioplasty and stenting of the subclavian artery.
  • Assessment of immediate and long-term outcomes.

Main Results:

  • CSSS can manifest with diverse symptoms, including angina and graft failure.
  • Percutaneous transluminal angioplasty and stenting of the stenotic subclavian artery effectively restore antegrade flow.
  • High technical success rates and significant improvement in clinical symptoms are observed post-intervention.

Conclusions:

  • Percutaneous revascularization is a safe and effective treatment option for CSSS.
  • Intervention restores graft perfusion and alleviates ischemic symptoms, offering excellent long-term outcomes.
  • Early diagnosis and treatment are crucial for managing this complication.

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