Acute occlusion of the left subclavian artery causing a non-ST-elevation myocardial infarction with subacute lung edema due to a coronary subclavian steal syndrome—A case report

Munk, Peter; Larsen, Alf Inge; Fjetland, Lars; Nilsen, Dennis W.T.

doi:10.1016/j.ijcard.2005.03.036

Cited by 15 publications

(14 citation statements)

References 17 publications

(6 reference statements)

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“…This phenomenon is known as coronarysubclavian steal syndrome (CSSS) (Fig. 1) and its consequences include angina, acute coronary syndrome, new-onset and decompensated heart failure, and malignant ventricular arrhythmias [14][15][16][17][18][19][20]. These serious and potentially catastrophic implications behoove screening for subclavian artery stenosis (SAS) prior to CABG and continued active surveillance for the interval development of SAS post CABG [21,22].…”

Section: Introductionmentioning

confidence: 99%

Review of coronary subclavian steal syndrome

Cua

Mamdani

Halpin

et al. 2017

Journal of Cardiology

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The clinical benefits of using the left internal mammary artery (LIMA) to bypass the left anterior descending artery are well established making it the most frequently used conduit for coronary artery bypass surgery (CABG). Coronary subclavian steal syndrome (CSSS) occurs during left arm exertion when (1) the LIMA is used during bypass surgery and (2) there is a high grade (≥75%) left subclavian artery stenosis or occlusion proximal to the ostia of the LIMA resulting in "stealing" of the myocardial blood supply via retrograde flow up the LIMA graft to maintain left upper extremity perfusion. Although CSSS was once thought to be a rare phenomenon, its prevalence has been underestimated and is becoming increasingly recognized as a serious threat to the success of CABG. Current guidelines are lacking on recommendations for screening of subclavian artery stenosis (SAS) pre- and post-CABG. We hope to provide an algorithm for SAS screening to prevent CSSS in internal mammary artery bypass recipients and review treatment options in the percutaneous era.

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Section: Introductionmentioning

confidence: 99%

Review of coronary subclavian steal syndrome

Cua

Mamdani

Halpin

et al. 2017

Journal of Cardiology

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“…In patients with a history of CABG, coronary subclavian steal was reported as flow reversal in the internal mammary artery graft [4] and recurrent ischemia and even myocardial infarction have been reported [5]. Salman et al have described a case series of SAS and different modalities of intervention [6].…”

Section: Discussionmentioning

confidence: 99%

Kink of Subclavian Artery Mimicking Stenosis

Kemal

Günsel

Kocaoğlu

et al. 2016

Case Reports in Cardiology

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The treatment for subclavian artery stenosis includes the more common endovascular therapy rather than surgical intervention in symptomatic patients. We present a case of a 79-year-old man with coronary artery bypass graft where subclavian artery stenosis was found incidentally. In this asymptomatic case, we have merged clinical and multiple imaging modalities to secure the diagnosis and treatment plan.

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“…Proximal stenosis of the subclavian artery can cause reductions of flow within the left IMA graft and result in myocardial ischemia with or without reversal of flow within the vertebral artery [6]. If the stenosis becomes critical or an acute occlusion occurs in the subclavian artery, this may result in myocardial infarction [1]. Many cases were reported about these phenomenon and stenting of subclavian artery results in improvement of ischemia [1, 5–8].…”

Section: Discussionmentioning

confidence: 99%

“…If the stenosis becomes critical or an acute occlusion occurs in the subclavian artery, this may result in myocardial infarction [1]. Many cases were reported about these phenomenon and stenting of subclavian artery results in improvement of ischemia [1, 5–8]. In all of these cases the coronary anatomy through CABG was reported to be mainly unaffected and no support left ventricle devises were needed.…”

Section: Discussionmentioning

confidence: 99%

“…Critical subclavian artery (SCA) stenosis is known to be associated with “steal syndrome” that usually presents with neurological symptoms. In patients with CAD after CABG and especially if the patient has extensive CAD, limited collaterals, and/or occluded grafts, SCA stenosis may presents as coronary subclavian steal syndrome which will present with recurrent ischemia [5, 7] and if this stenosis becomes critical this may results in a myocardial infarction [1]. …”

Section: Introductionmentioning

confidence: 99%

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High-Risk Acute Coronary Syndrome in a Patient with Coronary Subclavian Steal Syndrome Secondary to Critical Subclavian Artery Stenosis

Fanari

Abraham

Hammami

et al. 2014

Case Reports in Cardiology

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Patients with multivessel coronary artery disease are more likely to have extensive atherosclerosis that involves other major arteries. Critical subclavian artery (SCA) stenosis can result in coronary subclavian steal syndrome that may present as recurrent ischemia and even myocardial infarction in patients with coronary artery bypass graft (CABG). In patients with concomitant severe native coronary disease, occluded saphenous venous grafts (SVG) to other arteries, percutaneous intervention on critical subclavian artery (SCA) stenosis that will compromise the blood flow to left internal mammary graft (LIMA) and left anterior descending (LAD) artery will be a high-risk procedure and may be associated with cardiogenic shock, especially in patients with preexisting ischemic cardiomyopathy. The use of percutaneous left ventricular (LV) assist device like Impella will offer better hemodynamic support and coronary perfusion and therefore results in decreased myocardial damage, maximized residual cardiac function, and lower incidence of cardiogenic shock.

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Acute occlusion of the left subclavian artery causing a non-ST-elevation myocardial infarction with subacute lung edema due to a coronary subclavian steal syndrome—A case report

Cited by 15 publications

References 17 publications

Review of coronary subclavian steal syndrome

Review of coronary subclavian steal syndrome

Kink of Subclavian Artery Mimicking Stenosis

High-Risk Acute Coronary Syndrome in a Patient with Coronary Subclavian Steal Syndrome Secondary to Critical Subclavian Artery Stenosis

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