REPEAT EMBOLIZATION OF THE SIDE BRANCH OF THE INTERNAL MAMMARY ARTERYGRAFT BY GELATIN SPONGE PARTICLES AND MICRO-COILS

The internal mammary artery (IMA) is increasingly used as a coronary b ypass conduit because of better long-term patency and improved prognos is as compared with venous grafts. Previous investigators have suggest ed that the ''steal'' of blood flow of the IMA graft via the subclavia n artery or a persistent large side branch of the graft may lead to it s thinning. However, only a few reports have described the embolizatio n of a large side branch using a transcatheter procedure. We present a case of repeated embolization of a large lateral costal side branch o f the left internal mammary arterial graft applying gelatin sponge par ticles and micro coils, as well as angioplasty to the graft conduit, w ith resulting easing of chest pain. (C) 1995 Wiley-Liss, Inc.