Shinozaki Norihiko, Suzuki Toshihiko, Ikari Yuji
Department of Cardiology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, Japan,
Cardiovasc Interv Ther. 2014 Oct;29(4):368-71. doi: 10.1007/s12928-013-0242-4. Epub 2014 Jan 8.
A 78-year-old female was hospitalized because of multiple bone fracture caused by falling down. She undertook coronary artery bypass graft (CABG) using left internal mammary artery (LIMA) about 10 years ago. She complained chest pain on the day of admission with hypotension. Emergent angiogram revealed total occlusion of left subclavian artery (SCA). We re-canalized left SCA with stent. Hemodynamics and symptom dramatically improved after the procedure. Acute coronary syndrome due to SCA occlusion after CABG using LIMA was rare, but we have to consider the possibility. Endovascular therapy to SCA lesion might be a proper strategy for these cases.
一名78岁女性因摔倒导致多处骨折入院。她大约10年前接受了使用左乳内动脉（LIMA）的冠状动脉旁路移植术（CABG）。入院当天她主诉胸痛伴低血压。急诊血管造影显示左锁骨下动脉（SCA）完全闭塞。我们用支架重新开通了左SCA。术后血流动力学和症状显著改善。使用LIMA进行CABG术后因SCA闭塞导致的急性冠状动脉综合征很少见，但我们必须考虑到这种可能性。对SCA病变进行血管内治疗可能是这些病例的合适策略。
