Coronary subclavian steal syndrome: treatment by stenting of the left subclavian artery

A 48-year-old Turkish male presented with worsening angina and a painful left hand eight years after coronary artery bypass surgery. Coronary angiography showed extensive coronary atherosclerosis with patent vein grafts to his diagonal branch and right coronary arteries. There was a severe narrowing lesion in the left subclavian artery before the origin of the left internal mammary artery (LIMA), which appeared patent. Percutaneous subclavian angioplasty and stent implantation to the left subclavian artery stenosis restored normal flow to the left hand and the LIMA with abolition of his ischemic hand symptom and marked improvement of his angina.