Angiographic evaluation of a carotid-subclavian bypass graft in a patient with subclavian artery stenosis and left internal mammary artery bypass graft.

The incidence of coronary subclavian steal syndrome is estimated to be 0.4%. When revascularization is necessary, the preferred technique is the carotid-subclavian bypass graft. Failure of a carotid-subclavian graft is rare. We present a patient with subclavian stenosis who required reevaluation of both the carotid subclavian conduit and the left internal mammary bypass graft. A combined femoral and left brachial approach is recommended for evaluating the carotid-subclavian graft and left internal mammary artery graft in patients with bypassed subclavian artery stenosis and prior myocardial revascularization.