Transcatheter coil occlusion for treatment of left internal mammary‐anterior descending artery steal phenomenon

Abstract

A 60-yr-old female with previous bypass surgery including LIMA-LAD graft presented with unstable angina due to steal phenomenon caused by a large pectoral branch of LIMA. Transcatheter coil occlusion of the pectoral branch was successfully performed. This procedure should be considered in similar cases.

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

“…There are several reported cases of coronary steal attributed to the presence of large IMA side-branches in the literature [6][7][8][12][13][14][15][16][17][18][19][20][21][22][27][28][29][30]. Large IMA sidebranches have been noted to be present in up to 9% (41/459) of patients on preoperative angiography [23].…”

Lack of evidence for improvement in internal mammary graft flow by occlusion of side branch

“…A number of case reports have appeared in the literature showing successful embolization of side branches to relieve symptoms [1][2][3][4][5]. These reports are encouraging as regards to the feasibility and safety of the procedure.…”

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Coronary steal due to unligated side branches of an internal mammary artery graft has been reported previously [1][2][3]. Embolization of these side branches has been shown to result in symptomatic improvement, but objective evidence of improved flow to the coronary artery has been lacking.

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Novel technique for coil embolization of intercostal branch of internal mammary artery graft

“…Treatment of this clinical entity consists of elimination of the low-resistance vessel with surgery [4] or by transcatheter embolization [5][6][7][8][9]. The latter offers the advantages of a shortened hospitalization, the possibility of lower morbidity and mortality, and lower overall cost when compared to reoperation.…”