Coronary steal by IMA bypass graft side-branches: A novel therapeutic use of a new detachable embolization coil

A Diagnostic and Therapeutic Dilemma: An Unusual Complication of a Coronary Artery Bypass Surgery

“…The first report of acquired internal mammary to pulmonary arterial fistula after CABG was published in 1990 by Johnson et al 3 At least 14 other cases of internal mammary artery to pulmonary arterial fistulas following CABG have been reported 1–14 . However, this is the first report of extensive sytemic‐pulmonary shunting involving the LIMA, lateral thoracic and multiple intercostals as a CABG complication.…”

“…During the last decade, the use of percutaneous embolization has increased 12–14 . One of the potential complications with percutaneous embolization was the risk of embolizing microparticles into the coronary circulation 12 .…”

Optimal treatment of unligated side branch of internal mammary artery: Coil, amplatzer vascular plug or graft stent? A case report and literature review

“…Eisenhauer et al stated that the use of large numbers of small synthetic fiber coils in place of 1-2 coils may be more successful because of enhanced early thrombogenic activity. [10] With the same intention, we used four 2 mm/2 cm coils in our case. The reason for recanalization in the case presented could be that a number of long coils were used.…”

Use of the Amplatzer Vascular Plug® for treatment of coronary steal

“…Regardless of the controversy, the ability to effectively and safely treat patients with objective evidence of LAD ischemia in the presence of a large LIMA side branch remains important. While coil embolization [14], gelatin sponge particles [15] and surgical ligation [8] have been proposed as treatment options, the Amplatzer Vascular Plug® offers several unique advantages including ease of delivery, a wide range of device sizes and the ability to safely remove the device if placement location is not optimal without damage to the device or vessel. The Amplatzer Vascular Plug® is a self-expandable, cylindrical device made from nitinol, available in sizes ranging from 4 to 16 mm (in 2 mm increments) and has been used in a variety of clinical applications, including the occlusion of aortopulmonary collaterals [11], patent ductus arteriosus [16] and pulmonary arteriovenous malformations [17].…”