Successful percutaneous treatment of coronary steal syndrome with the amplatzer vascular plug 4 and coil embolization

Kahraman, Serkan; Ağaç, Mustafa Tarık; Demirci, Gökhan; Gürbak, İsmail; Panç, Cafer; Yıldız, Mustafa; Ertürk, Mehmet

doi:10.5582/irdr.2018.01083

Cited by 3 publications

(4 citation statements)

References 10 publications

(9 reference statements)

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“…and Kahraman et al . [ 7 8 ] reported coronary steal which occurred due to unligated LITA side branches. Januszek et al .…”

Section: Discussionmentioning

confidence: 99%

Internal Mammary Artery–saphenous Vein Y Anastomosis in Coronary Artery Bypass Grafting – Is there a Possibility of Coronary Steal?

Kumar,

Pandey

2024

Heart Views

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Recent advances in coronary revascularization include total arterial grafting, however, in a few cases, harvesting the right internal thoracic artery (RITA) is not possible due to various reasons. In such cases, where the aorta is also calcified, few surgeons perform Y anastomosis configuration with the left internal thoracic artery(LITA) and saphenous vein which can have disastrous complications. Our patient is a 65-year-old man who was diagnosed with multivessel coronary disease and presented with a coronary steal during coronary artery bypass grafting surgery. The RITA was not harvested due to osteoporosis sternum. LITA–saphenous vein Y anastomosis configuration was done as the aorta was calcified. The anastomosis was done between the LITA to the left anterior descending (LAD) artery and the Y arm saphenous vein was anastomosed to an obtuse marginal (OM)branch. He developed coronary steal following anastomosis of the Y graft to the OM branch. The patient had ischemic changes inside the operation theatre in LAD territory, hence grafts were revised following which the patient became stable. There is a high possibility of a coronary steal when the caliber of the Y arm does not match with the LITA. LITA–saphenous vein Y anastomosis can cause more complications as the saphenous vein is much bigger in caliber compared to the LITA.

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“…and Kahraman et al . [ 7 8 ] reported coronary steal which occurred due to unligated LITA side branches. Januszek et al .…”

Section: Discussionmentioning

confidence: 99%

Internal Mammary Artery–saphenous Vein Y Anastomosis in Coronary Artery Bypass Grafting – Is there a Possibility of Coronary Steal?

Kumar,

Pandey

2024

Heart Views

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“…Further, vascular plugs may be more suitable in medium or large side branches when there is concern for coil dislodgement or uncoiling 49 . In five case reports involving AVP deployment for LIMA side branch coronary steal ( N = 5 patients), four were technically successful with relief of stable angina and the fifth was associated with an inadvertent side branch dissection that ultimately occluded the vessel and relieved symptoms 6,37,38,41,50 …”

Section: Therapeutic Interventionsmentioning

confidence: 99%

“…A second commonly described occlusion method is the Amplatzer vascular plug which is a self-expanding cylindrical Nitinol mesh occlusion device. 41,49 Proposed benefits of the AVP include reduced fluoroscopy time and radiation use owing to its ease of rapid deployment. 47 when there is concern for coil dislodgement or uncoiling.…”

Section: Amplatzer Vascular Plugmentioning

confidence: 99%

“…49 In five case reports involving AVP deployment for LIMA side branch coronary steal (N = 5 patients), four were technically successful with relief of stable angina and the fifth was associated with an inadvertent side branch dissection that ultimately occluded the vessel and relieved symptoms. 6,37,38,41,50 4.3 | Covered stent within the LIMA A third percutaneous option described is deployment of a covered stent within the LIMA at the ostium of the side branch to prevent branch flow. 40 However, based on limited data, the restenosis rate of covered stents are as high as 31.6% at a mean 159-day follow-up.…”

Section: Amplatzer Vascular Plugmentioning

confidence: 99%

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Left internal mammary artery side branch intervention in the management of coronary steal syndrome following coronary artery bypass grafting

Mangels

Penny

Reeves

2019

Cathet Cardio Intervent

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Objective: The objective of this qualitative review is to summarize the pathophysiological and clinical data behind the clinical entity of left internal mammary artery (LIMA) side branch coronary steal as well as the potential diagnostic and therapeutic modalities available. Background: The presence of persistent unligated LIMA side branches following coronary artery bypass grafting has previously been associated with stable angina and acute coronary syndromes. However, despite numerous attempts to objectively demonstrate a coronary steal phenomenon, the pathophysiology of LIMA side branch flow diversion remains elusive and the clinical utility of intervention is not well elucidated. Methods: A review of literature and available data including case reports, case series, and investigational studies was performed. Results: Therapeutic closure of LIMA side branches has been reported in at least 44 patients and in at least 31 publications since 1990 and is associated with an 87.5% rate of freedom from angina amongst technically successful initial interventions. In all patients with pre-and post-stress testing, intervention was associated with an improvement and/or resolution of previously observed reversible ischemia. Conclusions: LIMA side branch coronary steal should remain an ongoing consideration in symptomatic patients with large unligated side branches on angiography, particularly when there is clear evidence of reversible ischemic on perfusion imaging.

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Percutaneous Closure of Coronary Artery Fistulas

Celli¹,

Alfares²,

Sandhu³

et al. 2023

Mastering Structural Heart Disease

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Successful percutaneous treatment of coronary steal syndrome with the amplatzer vascular plug 4 and coil embolization

Cited by 3 publications

References 10 publications

Internal Mammary Artery–saphenous Vein Y Anastomosis in Coronary Artery Bypass Grafting – Is there a Possibility of Coronary Steal?

Internal Mammary Artery–saphenous Vein Y Anastomosis in Coronary Artery Bypass Grafting – Is there a Possibility of Coronary Steal?

Left internal mammary artery side branch intervention in the management of coronary steal syndrome following coronary artery bypass grafting

Percutaneous Closure of Coronary Artery Fistulas

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