title: Internal mammary artery graft dissection: a case-based retrospective study and brief review.
abstract: The left internal mammary artery is the preferred graft for treating left anterior descending coronary artery disease. Dissection is a rare but grave sequela of internal mammary artery graft angiography. The available medical literature is scant, perhaps as a result of under-reporting. We report a case in which dissection of the internal mammary artery graft occurred during diagnostic angiography, and we discuss its management. In addition, we review the available literature and provide a retrospective analysis of the data from our own catheterization laboratory. In our single-center analysis of 542 cases of selective internal mammary artery graft angiography, we found only the single case of internal mammary artery graft dissection (0.2%) that we report here. Our review of the literature revealed 7 reported cases of internal mammary artery graft dissection, 3 of which were iatrogenic. There were no identifiable risk factors for such dissection. After treatment with angioplasty and stenting, all patients had good outcomes during follow-up.
authors.forename: Zeeshan
authors.initials: Z
authors.lastname: Khan
authors.forename: Faisal
authors.initials: F
authors.lastname: Latif
authors.forename: Tarun W
authors.initials: TW
authors.lastname: Dasari
mesh_terms: D017130:Angioplasty / Q000295:instrumentation; D017023:Coronary Angiography / Q000009:adverse effects*; D003324:Coronary Artery Disease / Q000601:surgery*; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis; D008297:Male; D008323:Mammary Arteries / Q000000981:diagnostic imaging / Q000293:injuries* / Q000637:transplantation*; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D016896:Treatment Outcome; D057772:Vascular System Injuries / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy
keywords: Aneurysm, dissecting/therapy; angioplasty, balloon, coronary; coronary artery bypass; dissection; internal mammary artery-coronary artery anastomosis/adverse effects; mammary arteries/dissection/injuries/surgery; postoperative complications; stents; treatment