Restenting for subclavian in-stent restenosis with symptomatic recurrent coronary-subclavian steal.
OBJECTIVE
To determine whether restenting for recurrent coronary-subclavian syndrome is technically feasible, provides durable results, and is a reasonable alternative to surgery.


METHODS
A 58-year-old woman with a left internal mammary artery (LIMA) bypass to the left anterior descending artery underwent angioplasty and stent placement for left subclavian stenosis and coronary-subclavian steal. Twenty-three months later, she returned with progressive angina and left arm claudication; heart catheterization demonstrated restenosis of the subclavian artery at the stent site with recurrence of the coronary-subclavian steal. Successful redo angioplasty and stenting resulted in normal antegrade flow through the LIMA graft. The patient has remained asymptomatic for 3 years without evidence of recurrent in-stent stenosis on serial noninvasive studies.


CONCLUSIONS
Restenting is technically feasible and appears to be a durable response to subclavian in-stent restenosis in patients with coronary subclavian steal.
Bates
Mark C
MC
Department of Surgery, Robert C. Byrd Health Sciences Center of West Virginia University, Charleston, West Virginia, USA. mark.bates@camc.org
AbuRahma
Ali F
AF
Stone
Patrick A
PA
D017130:Angioplasty / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D005260:Female; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications; D011859:Radiography; D012086:Reoperation; D015607:Stents / Q000009:adverse effects*; D013349:Subclavian Steal Syndrome / Q000000981:diagnostic imaging / Q000601:surgery*