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KMID : 0882420160910010037
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Korean Journal of Medicine
2016 Volume.91 No. 1 p.37 ~ p.41
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Coronary-subclavian Steal Syndrome in a Patient with Takayasu Arteritis
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Kim Min-Sun
Paik Nam-Young
Choi Seung-Hyuk
Kim Wook-Sung
Kim Sung-Mok
Jeon Pyoung
Kim Duk-Kyung
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Abstract
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A 37-year-old woman who had undergone coronary artery bypass grafting (CABG) surgery for left main and right coronary ostial lesions 2 years prior presented with angina and transient visual dimness. Computed tomography angiography showed a patent left internal mammary artery (LIMA) bypass graft and concentric narrowing with perivascular thickening around the arch vessels. The patient was diagnosed with Takayasu arteritis with coronary subclavian steal syndrome (CSSS). Thoracic angiography revealed severe stenosis of the left proximal subclavian artery (SCA) and reverse flow from the coronary artery to the distal left SCA via the LIMA graft. Successful percutaneous stenting of the left SCA was performed together with stenting of the right common carotid artery (CCA). The patient’s symptoms were completely resolved. This case is informative since it shows that Takayasu arteritis can manifest as angina due to coronary ostial lesions and then can involve arch vessels, which can lead to CSSS in patients with CABG.
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KEYWORD
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Takayasu arteritis, Coronary-subclavian steal syndrome, Coronary artery bypass, Off-pump
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