Symptomatic coronary-subclavian steal syndrome due to total occlusion of proximal left subclavian artery

摘要

Symptomatic coronary-subclavian steal occurs infrequently. We report a case involving angina pectoris in a patient with a patent left internal thoracic artery graft on the left anterior descending coronary artery and total occlusion of the proximal left subclavian artery.Recurrent angina after internal thoracic artery (ITA) coronary bypass surgery caused by significant proximal subclavian artery stenosis is an unusual complication of bypass surgery. The stenosis or occlusion of the subclavian artery proximal to the origin of the internal thoracic artery may result in reversal of ITA flow and produce myocardial ischemia. We present the case of a patient with both symptomatic occlusive disease of the subclavian artery and coronary artery disease in whom coronary-subclavian steal developed.