Hallisey M J, Rees J H, Meranze S G, Siegfeld A, Lowe R
Division of Vascular and Interventional Radiology, University of Connecticut School of Medicine, Hartford Hospital, USA.
J Vasc Interv Radiol. 1995 Jan-Feb;6(1):125-9. doi: 10.1016/s1051-0443(95)71076-4.
The coronary-subclavian artery steal (CSS) syndrome is caused by critical stenosis in the subclavian artery proximal to a bypass graft from the internal mammary artery (IMA) to the coronary artery. The stenosis results in retrograde flow in the IMA and steal from the coronary artery.
Percutaneous transluminal angioplasty (PTA) was performed in eight patients (five men, three women). In four patients (group 1), coronary ischemia had developed 0.5-70 months (mean, 31 months) after IMA-to-coronary artery bypass surgery. These four patients (mean age, 58 years; range, 44-68 years) underwent PTA of a single area of focal subclavian stenosis to treat CSS. In four other patients (group 2), atherosclerotic subclavian stenosis had developed proximal to a donor IMA before planned bypass surgery. These patients (mean age, 53 years; range, 50-57 years) underwent PTA of a single focal subclavian stenosis to prevent CSS.
Group 1 patients were free of myocardial ischemia at follow-up (mean follow-up, 39.0 months; range, 14-101 months). Three of four patients in group 2 underwent coronary artery bypass grafting with the ipsilateral IMA following PTA of the subclavian stenosis; they were free of angina at follow-up (mean follow-up, 14 months; range, 10-18 months).
PTA is a safe and efficacious short-term method for prevention and treatment of CSS syndrome.
冠状动脉-锁骨下动脉窃血（CSS）综合征是由锁骨下动脉在胸廓内动脉（IMA）至冠状动脉旁路移植术近端的严重狭窄所致。该狭窄导致IMA内血流逆行并从冠状动脉窃血。
对8例患者（5例男性，3例女性）实施经皮腔内血管成形术（PTA）。4例患者（第1组）在IMA至冠状动脉旁路移植术后0.5 - 70个月（平均31个月）出现冠状动脉缺血。这4例患者（平均年龄58岁；范围44 - 68岁）接受了针对单一局灶性锁骨下狭窄区域的PTA以治疗CSS。另外4例患者（第2组）在计划进行旁路移植术前，在供体IMA近端出现了动脉粥样硬化性锁骨下狭窄。这些患者（平均年龄53岁；范围50 - 57岁）接受了针对单一局灶性锁骨下狭窄的PTA以预防CSS。
第1组患者在随访时无心肌缺血（平均随访39.0个月；范围14 - 101个月）。第2组4例患者中有3例在锁骨下狭窄PTA后使用同侧IMA进行了冠状动脉旁路移植术；他们在随访时无心绞痛（平均随访14个月；范围10 - 18个月）。
PTA是预防和治疗CSS综合征的一种安全有效的短期方法。
