An Unusual Case of Bilateral Subclavian-Carotid Artery Graft Occlusion With Coronary Steal Syndrome Managed in the Cath Lab

作者：Wisneski Andrew D; Beyer Anna T; Shunk Kendrick A^*

来源：Journal of Invasive Cardiology, 2013, 25(1): E14-E16.

• carotid artery
• chronic total occlusion

A 65-year-old man, s/p coronary bypass surgery (CABG) with left internal mammary artery (LIMA) to the left anterior descending (LAD) artery 12 years previously, presented to his local hospital with left upper extremity pain, dizziness, falls, and chest pain. At the outside hospital, a proximal total left subclavian occlusion was found and the patient underwent left subclavian artery to common carotid artery (SCA-CCA) bypass surgery. Shortly thereafter, the patient developed right subclavian thrombosis, and underwent right SCA-CCA bypass surgery. Twenty days later, coronary steal symptoms recurred; troponin levels were elevated and ultrasound exam revealed bilateral SCA-CCA graft occlusion. The patient was then transferred to a tertiary care facility with a diagnosis of non-ST elevation myocardial infarct (NSTEMI). A successful endovascular procedure was performed in the cardiac catheterization laboratory with the use of coronary chronic total occlusion (CTO) devices, to treat the coronary steal syndrome. J INVASIVE CARDIOL 2013;25(1):E14-E16

• 出版日期2013-1