Lower extremity ischemia secondary to internal thoracic-coronary artery bypass grafting.
Vascular complications associated with the use of the internal thoracic artery as a conduit for coronary artery bypass are infrequent. However, acute limb-threatening ischemia can occur after the use of the internal thoracic artery for myocardial revascularization when this vessel forms an important collateral to an obstructed aortoiliac artery system. Although this is a rare complication, the consequences are devastating. Due to the risk of peripheral vascular insufficiency, we now perform simultaneous revascularization of the myocardium and the lower extremity when an internal thoracic artery that appears to be a major collateral to the ipsilateral aortoiliac system is used.
Kitamura
S
S
Department of Surgery III, Nara Medical College, Nara, Japan.
Inoue
K
K
Kawachi
K
K
Morita
R
R
Seki
T
T
Taniguchi
S
S
Kawata
T
T
D000208:Acute Disease; D000368:Aged; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging; D003097:Collateral Circulation; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging; D007511:Ischemia / Q000000981:diagnostic imaging / Q000209:etiology*; D007866:Leg / Q000098:blood supply*; D008297:Male; D011859:Radiography; D013895:Thoracic Arteries / Q000601:surgery*