Korean J Med.  2016 Aug;91(1):37-41. 10.3904/kjm.2016.91.1.37.

Coronary-subclavian Steal Syndrome in a Patient with Takayasu Arteritis

• Kim MS
• Paik NY
• Choi SH
• Kim WS
• Kim SM
• Jeon P
• Kim DK

• KMID: 2345582
• DOI: http://doi.org/10.3904/kjm.2016.91.1.37

Abstract

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.

Keyword

Takayasu arteritis; Coronary-subclavian steal syndrome; Coronary artery bypass, Off-pump

MeSH Terms

Adult
Angiography
Carotid Artery, Common
Constriction, Pathologic
Coronary Artery Bypass
Coronary Artery Bypass, Off-Pump
Coronary Vessels
Coronary-Subclavian Steal Syndrome*
Female
Humans
Mammary Arteries
Stents
Subclavian Artery
Takayasu Arteritis*
Transplants