title: Successful percutaneous revascularization of totally occluded left subclavian artery using orbital atherectomy.
abstract: Subclavian artery steal (SAS) after coronary artery bypass graft (CABG) has been reported to be as high as 3.4%. These patients with patent left internal mammary artery (LIMA) anastomosis will also have coronary-subclavian steal syndrome (CSSS). Percutaneous intervention (PCI) by balloon angioplasty (BA) and stenting has been done successfully for subclavian artery (SA) stenosis. The visibility of the vertebral artery (VA) and LIMA during BA and stent positioning is extremely important. Debulking total occlusions by orbital atherectomy (OA) and avoiding unnecessary BA, stenting across side branches may decrease the chance of plaque shifting and subsequent loss of flow especially if they have ostial disease. Herein we report successful OA, BA and stenting of chronic total occlusion (CTO) of proximal left subclavian artery in a patient with coronary-subclavian steal syndrome with preservation of LIMA and diseased left vertebral artery (VA).
authors.affiliation: Division of Cardiovascular Diseases, LSU Health Sciences Center Shreveport, LA, USA.
authors.forename: Nuri Ilker
authors.initials: NI
authors.lastname: Akkus
authors.forename: Faisal
authors.initials: F
authors.lastname: Bahadur
authors.forename: Mehmet
authors.initials: M
authors.lastname: Cilingiroglu
mesh_terms: D000800:Angioplasty, Balloon / Q000295:instrumentation; D017073:Atherectomy / Q000295:instrumentation / Q000379:methods*; D058686:Coronary-Subclavian Steal Syndrome / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008875:Middle Aged; D011859:Radiography; D015607:Stents; D013348:Subclavian Artery / Q000000981:diagnostic imaging; D013349:Subclavian Steal Syndrome / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome; D014711:Vertebral Artery / Q000000981:diagnostic imaging