An unusual case of left internal mammary artery ostial disease: clarifying role of intravascular ultrasound.

Stenosis at the origin of the left internal mammary artery graft is rare. We present a case with a suspected stenosis involving the origin of the left internal mammary artery that conventional angiography failed to demonstrate convincingly. Intravascular ultrasound illustrated a severe stenosis and the patient underwent successful stenting of the left internal mammary artery origin. The intravascular ultrasound finding of a dissection flap, just distal to the left internal mammary artery origin, suggests that local trauma to the vessel from prior catheterization procedures may have been responsible for the progressive narrowing at the left internal mammary artery ostium.