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Effective emergent endovascular recanalization for acute coronary syndrome with left subclavian artery occlusion in a prior coronary artery bypass graft patient

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Abstract

A 78-year-old female was hospitalized because of multiple bone fracture caused by falling down. She undertook coronary artery bypass graft (CABG) using left internal mammary artery (LIMA) about 10 years ago. She complained chest pain on the day of admission with hypotension. Emergent angiogram revealed total occlusion of left subclavian artery (SCA). We re-canalized left SCA with stent. Hemodynamics and symptom dramatically improved after the procedure. Acute coronary syndrome due to SCA occlusion after CABG using LIMA was rare, but we have to consider the possibility. Endovascular therapy to SCA lesion might be a proper strategy for these cases.

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Abbreviations

CABG:

Coronary artery bypass graft

LIMA:

Left internal mammary artery

OM:

Obtuse marginal branch

GEA:

Gastroepiploic artery

LAD:

Left anterior descending artery

SCA:

Subclavian artery

LMT:

Left main trunk coronary artery

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Authors and Affiliations

  1. Department of Cardiology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, Japan

    Norihiko Shinozaki, Toshihiko Suzuki & Yuji Ikari

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  1. Norihiko Shinozaki
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  2. Toshihiko Suzuki
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  3. Yuji Ikari
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Correspondence to Norihiko Shinozaki.

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Shinozaki, N., Suzuki, T. & Ikari, Y. Effective emergent endovascular recanalization for acute coronary syndrome with left subclavian artery occlusion in a prior coronary artery bypass graft patient. Cardiovasc Interv and Ther 29, 368–371 (2014). https://doi.org/10.1007/s12928-013-0242-4

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  • DOI: https://doi.org/10.1007/s12928-013-0242-4

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