title: Subclavian artery angioplasty proximal to a left internal mammary-coronary artery bypass graft: case report.
abstract: Subclavian artery angioplasty is an established treatment for subclavian steal syndrome and arm ischemia caused by subclavian stenosis. We report a case of angina pectoris caused by a subclavian artery stenosis proximal to a left internal mammary-coronary artery bypass graft. Angioplasty was performed without complication and with complete relief of symptoms. Reactive hyperemia was induced in the forearm and hand with a blood pressure cuff prior to angioplasty to increase blood flow to the arm, and to reduce the chance of graft embolization. Repeat angiography 6 months later confirmed continued patency of the subclavian artery and the graft and reversal of the steal physiology. The patient remains symptom free 15 months after angioplasty.
authors.affiliation: Division of Cardiovascular/Interventional Radiology, Jefferson Medical College, Philadelphia, Pennsylvania.
authors.forename: M C
authors.initials: MC
authors.lastname: Soulen
authors.forename: K L
authors.initials: KL
authors.lastname: Sullivan
mesh_terms: D000787:Angina Pectoris / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D000800:Angioplasty, Balloon; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000473:pathology; D003251:Constriction, Pathologic; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis; D008297:Male; D008875:Middle Aged; D011859:Radiography; D013348:Subclavian Artery / Q000000981:diagnostic imaging / Q000473:pathology