Percutaneous transluminal angioplasty of a surgically obstructed left internal mammary artery graft

We describe a case of an angioplasty of left internal mammary artery. This case had had a recent surgery and was found to have a stenosis at the site of a surgical clip. This was successfully dilated, and the patient became asymptomatic. Follow-up at one year revealed continual improvement.     

Pseudoaneurysm following successful excimer laser coronary angioplasty of a restenotic left internal mammary artery graft ostial lesion

Although significant left internal mammary artery graft ostial stenosis is extremely rare, the clinical importance can be profound. In this report we describe a case in which a restenotic left internal mammary artery graft ostial lesion was successfully opened with excimer laser coronary angioplasty. A resulting pseudoaneurysm spontaneously closed after conservative therapy.     

Coronary angioplasty of internal mammary artery graft

The internal mammary artery is being increasingly utilized as a conduit for coronary artery bypass operations. Early stenosis of the mammary artery due to either surgical technique or early graft atherosclerosis is a problem that requires repeated bypass operations, with increased morbidity and mortality. Percutaneous transluminal coronary angioplasty appears to be an attractive therapeutic modality in the treatment of internal mammary artery graft stenosis and may be accomplished easily by either the femoral or brachial approach. Further follow-up studies are required to validate the long-term results of angioplasty of internal mammary artery grafts.     

Laser angioplasty in a right coronary artery stent restenosis with the guidance of left internal mammary artery contrast injection: case report.

A 43-years-old male who underwent right coronary artery stent implantation 6 months ago presented with total occlusion of right coronary artery at proximal part of the stent without antegrade flow. We successfully used the left internal mammary artery contrast injections for guidance in all stages of the right coronary laser angioplasty intervention.     

Collateralization of an occluded left internal mammary artery coronary bypass graft

The left internal mammary artery (LIMA) is frequently utilized in coronary artery bypass grafting (CABG); adequate visualization of the LIMA bypass graft during diagnostic angiography is critical for determination of myocardial blood supply. We present a novel case of angiography via a left transradial approach demonstrating an occluded LIMA coronary bypass graft with antegrade flow maintained via a collateral branch from the ipsilateral thyrocervical trunk. Given the prevalence of LIMA use in CABG, it is critical to be aware of unusual configurations, including collateralization of a proximally occluded LIMA graft as described in this report.     

Percutaneous transluminal angioplasty of a stenosis at the origin of the left internal mammary artery graft: a case report

A case of percutaneous transluminal angioplasty of a high-grade stenosis at the origin of the left internal mammary graft is presented. An investigational angled-balloon dilating catheter was used.     

Iatrogenic left internal mammary artery-coronary vein anastomosis treated with covered stent deployment via retrograde percutaneous coronary sinus approach.

OBJECTIVES: Percutaneous treatment of acquired coronary fistula with covered stent BACKGROUND: Acquired aorto-coronary fistulae (ACF) is a rare complication of coronary artery bypass graft (CABG) surgery. Surgical repair has been generally recommended, but percutaneous techniques have also been described; coils were used primarily in smaller fistula while double umbrella or vascular occlusion devices were used in larger ones. To the best of our knowledge the use of coronary covered stent has never been reported. A 73-year-old man underwent CABG in November 2004 for unstable angina and left internal mammary artery (LIMA) was anastomosed to left anterior descending (LAD) coronary artery. Three months later he underwent a control angiogram to check for the reappearance of effort angina, which demonstrated an inadvertent LIMA-great cardiac vein (GCV) anastomosis. After discussions, an attempt to close the ACF with implantation of a covered stent was performed. METHODS: Using a percutaneous right internal jugular vein approach, coronary sinus was selectively cannulated and a 0.014-in. coronary guide wire was advanced selectively to the GCV, then a covered stent was deployed across the anastomotic site, obtaining the immediate occlusion of the ACF. RESULTS: No contrast medium flowed into the distal part of the GCV at the reinjection of the coronary sinus and a selective injection into LIMA showed the absence of flow through LIMA, confirming the occlusion of the anastomotic site. CONCLUSIONS: We have demonstrated successful occlusion of an iatrogenic ACF by using percutaneous stenting of GCV with covered stent via coronary sinus approach, which seems to be technically less demanding, safer, and time sparing.     

Cortical blindness after left internal mammary artery to left anterior descending coronary artery graft angiography

We describe a case of transient cortical blindness following internal mammary artery to left anterior descending coronary artery graft angiography. This dramatic, infrequent, and self-limiting complication so far has not been described in the cardiovascular literature. In the present era of internal mammary artery use for the left coronary artery grafting, the angiographer should be familiar with the diagnosis, prevention, and management of complications previously seen mostly during the posterior cerebral circulation angiography.     

Symptomatic atraumatic dissection of a left internal mammary artery graft five years after coronary artery bypass graft surgery

The case of a spontaneous dissection of a left internal mammary artery grafted on to the diagonal branch and the left anterior descending artery is reported. The clinical and diagnostic features of this condition are discussed. Despite an extensive literature search, no such case was found. The present case is the first to be reported. It was speculated that extensive kinking of the left internal mammary artery contributed to the pathogenesis of this syndrome.     

Stenting of the right internal mammary artery graft and right coronary artery via a femoral approach

We describe a case of balloon angioplasty and stenting of the right internal mammary artery (RIMA) graft anastomosis and the native right coronary artery through an in situ RIMA graft using two Bard XT stents (USCI Division of C.R. Bard, Inc., Billerica, Massachusetts). This case illustrates the feasibility of transluminal angioplasty and stenting of RIMA grafts and the native coronary artery using a femoral artery approach.     

Transluminal angioplasty of a stenosis of an internal mammary artery graft

Stricture of an internal mammary artery graft was successfully dilated by percutaneous angioplasty in a young man who had recurrent angina soon after bypass surgery.     

Stenting the distal anastomotic site of the left internal mammary artery graft: a case report

The major problem associated with the long-term patency of the internal mammary artery graft is the early occurrence of stenosis usually at its distal anastomotic site; its management by balloon angioplasty has been associated with a high success rate. We report the case of an unsuccessful balloon angioplasty of an anastomotic stenosis of a left internal mammary artery graft that was successfully managed by stenting with one-half of a Palmaz-Schatz stent. © 1994 Wiley-Liss,Inc..     

Restoration of patency of left internal mammary artery graft with progression of the underlying left anterior descending coronary artery disease

The use of the left internal mammary artery (LIMA) to graft a borderline lesion in the left anterior descending coronary artery (LAD) has been associated with distal narrowing and occlusion of the LIMA. We present a patient in whom the LIMA occluded 1 year after coronary artery bypass, but was found to be fully patent 4 years later, after progression of the native LAD disease. Cathet. Cardiovasc. Diagn. 42:213–215, 1997. © 1997 Wiley-Liss, Inc.     

Balloon expandable stent implantation of a stenosis at the origin of the left internal mammary artery graft: A case report

We describe a case of percutaneous transluminal coronary angioplsty in which we implanted a balloon expandable Palmaz-Schatz stent into a high-grade restenosed lesion at the origin of the left internal mammary graft.     

Balloon expandable stent implantation of a stenosis at the origin of the left internal mammary artery graft: a case report.

We describe a case of percutaneous transluminal coronary angioplasty in which we implanted a balloon expandable Palmaz-Schatz stent into a high-grade restenosed lesion at the origin of the left internal mammary graft.