6. Coronary-subclavian steal syndrome, treated by baloon-expandable peripheral stent. Case report

Authors

  • STENT. CASE REPORT PERIPHERAL Kazakhstan, купированию клиники стенокардии и восстановлению адекватного кровотока в левой верхней конечности в раннем послеоперационном периоде
  • A.V. Sapunov Kazakhstan, купированию клиники стенокардии и восстановлению адекватного кровотока в левой верхней конечности в раннем послеоперационном периоде
  • I.Ye. Sagatov Kazakhstan, купированию клиники стенокардии и восстановлению адекватного кровотока в левой верхней конечности в раннем послеоперационном периоде
  • B.K. Ormanov Kazakhstan, купированию клиники стенокардии и восстановлению адекватного кровотока в левой верхней конечности в раннем послеоперационном периоде
  • Ye. Ye. Abilkhanov Kazakhstan, купированию клиники стенокардии и восстановлению адекватного кровотока в левой верхней конечности в раннем послеоперационном периоде

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Abstract

Patient K., male, 65 years old, suffering from type 2 diabetes, adhering to basic therapy, in year 2018 underwent isolated internal mammary bypass surgery for coronary artery disease. In 2022, due to a deterioration in general well-being in the form of stabbing pains behind the sternum, shortness of breath during physical exertion, pain and numbness of the left upper limb, he was scheduled for coronary angiography with shuntography. During routine shuntography through the left radial access, the presence of retrograde filling of the LIMA graft was established, indicating the presence of the phenomenon of coronary-subclavian steal. Elimination of hemodynamically significant stenosis of the left subclavian artery with a peripheral balloon-expandable stent led to successful remodeling of left coronary hemodynamics, relief of angina symptoms, and restoration of adequate blood flow in the left upper limb in the early postoperative period.

Keywords

steal syndrome, CABG, LIMA, stent, bypass, reverse flow

References

  1. Harjola PT, Valle M: The importance of aortic arch or subclavian angiography before coronary reconstruction. Chest 1974; 66: 436–438
  2. Tyras DH, Barner HB. Coronary-Subclavian Steal. Arch Surg. 1977;112(9):1125–1127. doi:10.1001/archsurg.1977.01370090107023
  3. Iglesias JF, Degrauwe S, Monney P, Glauser F, Qanadli SD, Eeckhout E, Muller O. Coronary subclavian steal syndrome and acute anterior myocardial infarction: a new treatment dilemma in the era of primary percutaneous coronary intervention. Circulation 2015;132(1):70–1
  4. Papatheodorou N, Argyriou C, Androutsopoulou VA, Chrisafis I, Mikroulis D, Georgiadis GS. Unmasking the Coronary-Subclavian Steal Syndrome: The Culprit Lies in the Subclavian Artery. A Report of a Case and Review of the Literature. Ann Vasc Surg. 2021 Jul;74:524.e9-524.e15. doi:10.1016/j.avsg.2021.02.009.Epub2021Apr6.PMID:33836226
  5. Bennett Cua, Natasha Mamdani, David Halpin, Sunny Jhamnani, Sasanka Jayasuriya, Carlos Mena-Hurtado. Review of coronary subclavian steal syndrome. JCC-V70, I5, P432-437, 2017. DOI:https://doi.org/10.1016/j.jjcc.2017.02.012
  6. Rafailidis V, Li X, Chryssogonidis I, Rengier F, et al. Multimodality Imaging and Endovascular Treatment Options of Subclavian Steal Syndrome. Can Assoc Radiol J 2018;69:493–507
  7. ESC Scientific Document Group, 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS): Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries Endorsed by: the European Stroke Organization (ESO) The Task Force for the Diagnosis and Treatment of Peripheral Arterial Diseases of the European Society of Cardiology (ESC) and of the European Society for Vascular Surgery (ESVS), European Heart Journal, Volume 39, Issue 9, 01 March 2018, Pages 763–816, https://doi.org/10.1093/eurheartj/ ehx095
  8. Che WQ, Dong H, Jiang XJ, Peng M, Zou YB, Qian HY, Zhang HM, Wu HY, Yang YJ, Gao RL. Stenting for left subclavian artery stenosis in patients scheduled for left internal mammary artery-coronary artery bypass grafting. Catheter Cardiovasc Interv 2016;87(Suppl. 1):579–88
  9. Tariq S, Tuladhar S, Wingfield E, Poblete H. Coronary subclavian steal syndrome unamenable to angioplasty successfully managed with subclavian-subclavian bypass. Case Rep Vasc Med. 2012;2012:784231. doi:10.1155/2012/784231.Epub2012Apr9.PMID:22937471;PMCID:PMC3420585
  10. Lawton J, Tamis-Holland J, et al. 2021 ACC/ AHA/SCAI Guideline for Coronary Artery Revascularization. J Am Coll Cardiol. 2022 Jan, 79 (2) e21–e129.https://doi.org/10.1016/j. jacc.2021.09.006

Published

2022-10-10

Issue

No. 3 (2022)

Section

Статьи