Tehran University Medical Journal (Nov 2007)
Non- cardiac surgery for the treatment of angina pectoris due to coronary- subclavian steal syndrome: a case report
Abstract
Background: The stenosis or occlusion of subclavian artery proximal to origin of internal mamary artery (IMA) may cause reversal of the flow of this vessel to subclavian artery and if IMA has been used as a conduit for myocardial revascularization it may cause myocardial and/ or brain ischemia.Case report: The reported patient had diffuse coronary and peripheral atherosclerosis and stenosis of the proximal left subclavian artery, who developed symptomatic myocardial ischemia resulting from coronary- subclavian steal syndrome as a result of flow reversal of IMA, used for bypass surgery, treated by subclavian to subclavian graft surgery.Conclusion: Because subclavian artery stenosis is very important in patients who are candidate for CABG, and it has a low incidence, authors suggest that before coronary angiography blood pressure of both hands should be measured for screening, and if more than 20 mmHg difference is observed, subclavian artery angiography is recommended. This approach is emphasized in those with history of peripheral artery disease.
