An angiographic consideration prior to coronary bypass graft surgery: importance of routine selective angiography of the internal mammary artery prior to myocardial revascularization.

The collateral perfusion via the hypertrophied internal thoracic arteries and rich anastomosis between the epigastric arteries reconstituting femoral artery are an important route in patients with peripheral vascular disease (chronic aortoiliac occlusion), providing blood flow to the lower extremities. Selective angiography of the internal thoracic artery plays a major role in the preoperative evaluation in patients with severe aortoiliac occlusive disease undergoing coronary bypass surgery and may prevent a major potential postoperative complication of acute lower extremity ischemia in these patients.