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A case of LIMA side branch coronary steal syndrome: a role for embolization

Andrea Picci1, Giuseppe Certo1, Fabrizio Ceresa2

  • 1Division of Cardiology, A.O. Papardo, Messina, Italy.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|October 16, 2024
PubMed

Insights

A patent internal mammary artery side branch can cause coronary steal after bypass surgery. Coil embolization effectively treated this condition in a patient with recurrent angina, improving blood flow and symptoms.

Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology

Background:

  • Coronary artery bypass grafting (CABG) is a common procedure for myocardial revascularization.
  • Failure to ligate side branches of the internal mammary artery (IMA) can lead to complications such as coronary steal syndrome.

Observation:

  • A 56-year-old male patient experienced recurrent angina six months post-CABG.
  • Coronary angiography revealed a patent left internal mammary artery (LIMA) with a significant side branch.

Findings:

  • Inducible ischemia was demonstrated in the affected myocardial territory.
  • Percutaneous coil embolization of the LIMA side branch was successfully performed.
  • The procedure improved coronary blood flow and resolved the patient's clinical symptoms.

Implications:

  • Coil embolization is an effective percutaneous treatment for coronary steal caused by patent IMA side branches.
  • This technique offers a minimally invasive option for managing post-CABG complications.
  • Successful treatment can restore myocardial perfusion and alleviate angina symptoms.

Keywords:
ANCO ‐ AngiographyCAD ‐ Coronary Artery DiseaseCoil/Device/TranscatheterCoronaryCoronary Bypass/EndarterectomyEMBC ‐ EmbolizationSBYP ‐ Surgery

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