title: Eversion Subclavian Endarterectomy and Transposition for Coronary-Subclavian Steal Syndrome in a Patient with Refractory Angina Pectoris.
abstract: Late onset of angina pectoris associated with subclavian artery (SA) atherosclerotic occlusive disease is a rare and recognized cause of myocardial ischemia when the lesion is proximal to a left internal mammary artery (LIMA) to coronary bypass. The symptoms typically exacerbate by increasing the flow demand in the extremity; this phenomenon is known as late coronary-subclavian steal syndrome. We describe the case of a 66-year-old woman who underwent coronary artery bypass grafting from the LIMA to the left anterior descending coronary artery in 2000. Years later, she experienced refractory angina pectoris associated to an occlusive lesion in the proximal left SA. SA endarterectomy with eversion technique and subclavian-carotid transposition restored the antegrade flow with resolution of the symptomatology.
authors.affiliation: Department of Surgery, Section of Vascular Surgery and Endovascular Therapy, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, Mexico. Electronic address: carlos.a.hinojosa@gmail.com.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Hinojosa
authors.affiliation: Department of Surgery, Section of Vascular Surgery and Endovascular Therapy, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, Mexico.
authors.forename: Javier E
authors.initials: JE
authors.lastname: Anaya-Ayala
authors.affiliation: Department of Surgery, Section of Vascular Surgery and Endovascular Therapy, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, Mexico.
authors.forename: Hugo
authors.initials: H
authors.lastname: Laparra-Escareno
authors.affiliation: Department of Interventional Radiology, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, Mexico.
authors.forename: Manuel
authors.initials: M
authors.lastname: Guerrero-Hernandez
authors.affiliation: Department of Cardiology, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, Mexico.
authors.forename: Jaime
authors.initials: J
authors.lastname: Galindo-Uribe
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000209:etiology*; D058686:Coronary-Subclavian Steal Syndrome / Q000150:complications / Q000601:surgery*; D004691:Endarterectomy; D005260:Female; D006801:Humans