Percutaneous angioplasty of internal mammary artery graft stenosis: Case report and discussion

Abstract

Percutaneous transluminal coronary angioplasty (PTCA) was successfully used for the first time in 1977. With experience, its application broadened to include multiple lesions, complex anatomical stenoses, multiple vessels, and saphenous vein aorto-coronary bypass grafts. This case demonstrates successful internal mammary graft angioplasty with continued long-term (eight months) success, documented angiographically.

Initial and subsequent angiographic outcome of percutaneous transluminal angioplasty performed on internal mammary artery grafts.

“…(184/201).5-10 [25][26][27][28][29][30][31][32][33][34][35][36] The overall success rate of first angioplasty was relatively lower in the present study, which may be explained by our inclusion of 12/48 (25%) totally or subtotally occluded internal mammary artery grafts. Most previous reports contained no or only a few cases with totally occluded internal mammary artery grafts.…”

Percutaneous transluminal coronary angioplasty of gastroepiploic artery graft

“…A higher rate of long-term patency of GEAs is expected than that of SVGs because of the histologic similarity between GEA and IMA [ 11, 121. In the literature, the short-term patency rate of GEA grafts is 95% 11-71. Most IMA graft stenoses are probably due to technical problems soon after surgery, but in some instances a local proliferative or hyperplastic myointimal response cannot be excluded [8]. The causes of GEA graft stenoses may be the same.…”

Percutaneous transluminal angioplasty involving internal mammary artery bypass grafts: A femoral approach

“…From the percutaneous femoral approach, manipulation of a standard 8 French guiding catheter to engage the origin of either the right or left IMA may be cumbersome and awkward [5,6]. The origin of the proximal portion of the IMA frequently is at a severe angle from its respective subclavian vessel.…”