Successful percutaneous revascularization of totally occluded left subclavian artery using orbital atherectomy

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• 作者：Nuri Ilker Akkus ; Faisal Bahadur ; Mehmet Cilingiroglu
• 关键词：Coronary&ndash ; subclavian steal syndrome ; Orbital atherectomy ; Stent
• 刊名：Cardiovascular Revascularization Medicine
• 出版年：2012
• 出版时间：July-August, 2012
• 年：2012
• 卷：13
• 期：4
• 页码：234-237
• 全文大小：668 K

文摘

Subclavian artery steal (SAS) after coronary artery bypass graft (CABG) has been reported to be as high as 3.4 % . These patients with patent left internal mammary artery (LIMA) anastomosis will also have coronary-subclavian steal syndrome (CSSS). Percutaneous intervention (PCI) by balloon angioplasty (BA) and stenting has been done successfully for subclavian artery (SA) stenosis. The visibility of the vertebral artery (VA) and LIMA during BA and stent positioning is extremely important. Debulking total occlusions by orbital atherectomy (OA) and avoiding unnecessary BA, stenting across side branches may decrease the chance of plaque shifting and subsequent loss of flow especially if they have ostial disease. Herein we report successful OA, BA and stenting of chronic total occlusion (CTO) of proximal left subclavian artery in a patient with coronary-subclavian steal syndrome with preservation of LIMA and diseased left vertebral artery (VA).