Stenting for spontaneous left internal mammary artery dissection: A case report

Abstract

We present a case of a spontaneously occurring mid LIMA dissection found on routine cardiac catheterization. We report our evaluation and intervention for this exceedingly rare phenomenon.

Chronic dissection of internal mammary artery graft

“…Internal mammary artery (IMA) graft dissection is a rare event that can cause angina pectoris and acute myocardial infarction [1][2][3][4]. To the best of our knowledge, the present case is the first case of unhealed chronic dissection of IMA graft.…”

“…Optimal treatment for IMA graft dissection has not been defined. Although successful stenting to treat IMA graft dissections have been reported [1,3,4], percutaneous intervention has a potential risk for extension of dissection [6] and perforation. In the present case, the LIMA dissection site is tortuous.…”

“…To the best of our knowledge, the present case is the first case of unhealed chronic dissection of IMA graft. IMA graft dissection can occur spontaneously [1][2][3] or secondary to injury during cardiac catheterization [4], angioplasty [5], or cardiac surgery. The cause of IMA graft dissection is unclear in the present case.…”

Spontaneous Spiral Dissection of Left Internal Thoracic Artery Graft

“…5,6) This may occur while harvesting the graft from the chest wall and during creation of the anastomotic site. 7) Graft failure requiring revascularization may be due to atherosclerotic disease, thrombus formation, or intimal proliferation. 5,7) LITA graft dissection is very rare as a cause of graft failure.…”

“…7) Graft failure requiring revascularization may be due to atherosclerotic disease, thrombus formation, or intimal proliferation. 5,7) LITA graft dissection is very rare as a cause of graft failure. Extensive kinking of the LITA during the surgical procedure or strenuous physical movement has been reported as a possible cause of LITA dissection.…”