Mj. Hallisey et al., USE OF ANGIOPLASTY IN THE PREVENTION AND TREATMENT OF CORONARY-SUBCLAVIAN STEAL SYNDROME, Journal of vascular and interventional radiology, 6(1), 1995, pp. 125-129
PURPOSE: The coronary-subclavian artery steal (CSS) syndrome is caused
by critical stenosis in the subclavian artery proximal to a bypass gr
aft from the internal mammary artery (IMA) to the coronary artery. The
stenosis results in retrograde flow in the IMA and steal from the cor
onary artery. PATIENTS AND METHODS: Percutaneous transluminal angiopla
sty (PTA) was performed in eight patients (five men, three women). In
four patients (group 1), coronary ischemia had developed 0.5-70 months
(mean, 31 months) after IMA-to-coronary artery bypass surgery. These
four patients (mean age, 58 years; range, 44-68 years) underwent PTA o
f a single area of focal subclavian stenosis to treat CSS. In four oth
er patients (group 2), atherosclerotic subclavian stenosis had develop
ed proximal to a donor IMA before planned bypass surgery. These patien
ts (mean age, 53 years; range, 50-57 years) underwent PTA of a single
focal subclavian stenosis to prevent CSS. RESULTS: Group 1 patients we
re free of myocardial ischemia at follow-up (mean follow-up, 39.0 mont
hs; range, 14-101 months). Three of four patients in group 2 underwent
coronary artery bypass grafting with the ipsilateral IMA following PT
A of the subclavian stenosis; they were free of angina at follow-up (m
ean follow-up, 14 months; range, 10-18 months). CONCLUSION: PTA is a s
afe and efficacious short-term method for prevention and treatment of
CSS syndrome.