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Percutaneous transluminal subclavian angioplasty in a patient with postoperative angina
G W Laub1, S Muralidharan, H Naidech
1Department of Surgery, Deborah Heart and Lung Center, Browns Mills, New Jersey 08015.
Insights
Subclavian artery stenosis, a rare cause of angina after internal mammary artery bypass, can be successfully treated with angioplasty. This minimally invasive approach avoids additional surgery for patients with coronary revascularization.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Vascular Surgery
Background:
- Subclavian artery stenosis is an uncommon complication in patients previously treated with internal mammary artery grafts for coronary artery disease.
- This condition can manifest as angina, mimicking symptoms of ongoing coronary ischemia.
- The standard treatment involves surgical bypass grafting of the affected subclavian artery.
Observation:
- A patient presented with angina following coronary revascularization utilizing an internal mammary artery graft.
- Diagnostic evaluation revealed significant stenosis of the subclavian artery.
Findings:
- Percutaneous transluminal subclavian artery angioplasty was successfully performed.
- The angioplasty procedure effectively treated the subclavian artery stenosis.
Implications:
- Percutaneous transluminal angioplasty offers a less invasive alternative to surgical revascularization for subclavian artery stenosis.
- This approach can successfully manage angina in patients with prior coronary artery bypass grafting.
- Minimally invasive techniques may improve patient outcomes and reduce the need for repeat surgical interventions.
Abstract:
Subclavian artery stenosis is a rare cause of angina in patients who have undergone coronary revascularization using the internal mammary artery. The traditional approach to this problem is surgical revascularization of the subclavian artery with a bypass graft. We report the successful treatment of a patient with this condition using percutaneous transluminal subclavian artery angioplasty, obviating an additional surgical procedure.