Direct stenting of a transradial left internal mammary artery graft

Taking the transfemoral approach when performing a left internal mammary artery (LIMA) graft intervention is generally recognized as posing significant technical challenges. However, little has been reported on alternative transradial approaches to LIMA. In this report, we present our experience in a patient who had anastomosis-site LIMA graft stenosis and was successfully treated with direct stenting. We used a 6-French Kimny guiding catheter inserted through the left radial artery, even though the procedure was complicated by an acute occlusion of a LIMA body, requiring bail-out stenting following intra-aortic balloon pump support and temporary cardiac pacing. The patient was discharged 6 days after the procedure and remains asymptomatic during follow-up visits. Our results suggest that a transradial approach is feasible for LIMA intervention procedures.