Subclavian artery intervention with vertebral embolic protection.
Knowing the location of the vertebral and the internal mammary artery ostia is crucial during proximal subclavian artery percutaneous intervention to prevent inadvertent injury to either artery. We report a case of severe proximal left subclavian artery stenosis in a patient with a three-vessel disease referred to coronary artery bypass graft surgery. Retrograde angiography via left radial access allowed visualization of the left internal mammary artery and the left vertebral artery ostia and placement of a Filterwire in the left vertebral artery. The proximal left subclavian artery was successfully stented without complications. Debris was retrieved in the Filterwire.
Michael
Tesfaldet T
TT
University of Texas Southwestern Medical School, VA North Texas Healthcare System, Dallas, TX 75216, USA.
Banerjee
Subhash
S
Brilakis
Emmanouil
E
D015901:Angiography, Digital Subtraction; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation; D001026:Coronary Artery Bypass; D023921:Coronary Stenosis / Q000150:complications / Q000601:surgery; D004617:Embolism / Q000209:etiology / Q000517:prevention & control*; D005374:Filtration / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008323:Mammary Arteries / Q000000981:diagnostic imaging; D008875:Middle Aged; D012720:Severity of Illness Index; D015607:Stents; D013349:Subclavian Steal Syndrome / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D016896:Treatment Outcome; D014711:Vertebral Artery / Q000000981:diagnostic imaging*