Preoperative semi-selective left internal mammary artery angiography: easy, safe, necessary and worthy

The left internal mammary artery is the graft of choice for coronary artery bypass surgery. The necessity for preoperative internal mammary artery angiography is still controversial. We designed a prospective left internal mammary angiography for evaluating the risk of stenosis in the left internal mammary and subclavian artery, and the risk and the necessity for pre-operative internal mammary artery angiography.

Eighty-six patients were included in a prospective study for semi-selective left internal mammary artery angiography during cardiac catheterization via the left radial or femoral approach. Stenosis of the left internal mammary and proximal left subclavian arteries was calculated with DCA; Chi2 analysis was used for analyzing the correlation between the risk factors and arterial stenosis.

One patient (1.2%) showed left internal mammary artery stenosis and 5 (5.8%) showed proximal left subclavian artery stenosis. No complications were found in all cases. The only significant factor affecting left subclavian or internal mammary artery stenosis was the female sex. All patients tolerated the procedure well.

Semi-selective left internal mammary artery angiography is a safe and easy procedure that should be performed routinely for patients with CAD prior to coronary artery bypass surgery.