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When a subclavian artery is equivalent to STEMI of left main coronary artery: a case report

Abdelrahman Elhakim1, Mohamed Elhakim2, Derk Frank3

  • 1Interventional Cardiology Consultant Schleswig, Holstein University Hospital-Kiel, Arnold-Heller-Street 3, 24105, Kiel, Germany. ayelhakim1985@yahoo.com.

BMC Cardiovascular Disorders
|May 19, 2025
PubMed

Insights

An 81-year-old man with cardiogenic shock and ST-elevation myocardial infarction (STEMI) underwent successful percutaneous intervention. This restored blood flow via the left internal mammary artery (LIMA), stabilizing his condition.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Surgery

Background:

  • The patient presented with cardiogenic shock and ST-elevation myocardial infarction (STEMI).
  • He had a history of ischemic heart disease and coronary artery bypass graft (CABG).

Purpose of the Study:

  • To describe a successful percutaneous intervention for left main coronary artery and left internal mammary artery (LIMA) occlusion.
  • To highlight the restoration of coronary circulation in a critical STEMI case.

Main Methods:

  • Coronary angiography revealed left main coronary artery occlusion and left subclavian artery occlusion proximal to the LIMA origin.
  • Percutaneous intervention was performed proximal to the LIMA origin.

Main Results:

  • Immediate restoration of antegrade flow in the left internal mammary artery (LIMA) to the left coronary circulation.
  • Hemodynamic stabilization and symptom relief were achieved post-intervention.

Conclusions:

  • Percutaneous intervention proximal to the LIMA origin is a viable strategy for managing complex coronary and LIMA occlusions.
  • This approach can effectively restore coronary blood flow and improve outcomes in STEMI patients.

Keywords:
Case reportCoronary artery bypass graftCoronary subclavian steal syndromeMyocardial infarctionSubclavian artery stenosis

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