Concomitant coronary and subclavian steal caused by ipsilateral subclavian artery stenosis and arteriovenous fistula in a hemodialysis patient.
Patients with chronic renal failure, because of concomitant conventional cardiovascular and uremia-associated risk factors, are at risk of developing diffuse and accelerated atherosclerosis involving both the coronary and peripheral territories. We report an end-stage renal failure patient with a history of coronary artery bypass surgery who developed both angina and dizziness during hemodialysis via a left forearm arteriovenous fistula. Magnetic resonance imaging diagnosed the presence of significant subclavian artery stenosis. The patient then underwent successful percutaneous stenting of the left subclavian artery. His angina and dizziness symptoms resolved subsequently.
Lee
Pui-Yin
PY
Division of Cardiology, Department of Medicine, Queen Mary Hospital, Hong Kong, China.
Ng
William
W
Chen
Wai-Hong
WH
D000368:Aged; D000800:Angioplasty, Balloon; D001164:Arteriovenous Fistula / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D001783:Blood Flow Velocity / Q000502:physiology; D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D005542:Forearm / Q000098:blood supply* / Q000000981:diagnostic imaging; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis; D007676:Kidney Failure, Chronic / Q000628:therapy; D018810:Magnetic Resonance Angiography; D008297:Male; D008323:Mammary Arteries / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D012039:Regional Blood Flow / Q000502:physiology; D006435:Renal Dialysis; D012501:Saphenous Vein / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D013349:Subclavian Steal Syndrome / Q000150:complications* / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D018615:Ultrasonography, Doppler, Color