BACKGROUND: The optimal management of @entity1 undergoing coronary artery bypass grafting (CABG) who have proximal @entity3526 ( @entity3526 ) is not well established. @entity3526 may lead to flow reversal through a patent in situ internal mammary artery graft, resulting in @entity741 ( @entity19820 ). We review our experience in prevention and management of @entity19820 . METHODS: The medical records of @entity1 who received treatment of symptomatic @entity19820 were reviewed. @entity1 who underwent subclavian artery revascularization before CABG were also included in our review. @entity1 demographic data, findings at presentation, imaging and treatment methods, and short-term and intermediate-term results were analyzed. RESULTS: Over 4 years, 14 @entity1 with combined subclavian and @entity453 were identified. Nine @entity1 had @entity951 (n = 8) and/or @entity712 (n = 2) after CABG (post-CABG group). Four @entity1 underwent treatment of @entity3526 and one underwent treatment of recurrent @entity850 before or during CABG (pre-CABG group). Among this pre-CABG group, one @entity1 had symptoms of @entity613 ; the other four @entity1 had no symptoms. A blood pressure gradient was commonly noted between both arms. An angiogram confirmed the proximal location of @entity3526 in all @entity1 , and established the presence of flow reversal in a patent internal mammary artery graft in the post-CABG group. Operative management consisted of percutaneous transluminal angioplasty (PTA) and stenting of the subclavian lesion in 11 @entity1 , PTA only in 2 @entity1 , and carotid-subclavian bypass grafting in 1 @entity1 . No known perioperative complications or morbidity was encountered in either group. Mean follow-up was 29 months, during which @entity850 recurred in two @entity1 , along with associated cardiac symptoms. In both @entity1 repeat angioplasty was successful, for an assisted primary patency rate of 100%. CONCLUSION: PTA and stenting to treat @entity3526 appears to provide effective protection from and treatment of @entity19820 over the short and intermediate terms. A surveillance program is essential because of the risk for recurrent @entity850 . Continued follow-up is necessary to determine long-term efficacy of this treatment compared with more conventional surgical approaches.

Endovascular therapy in prevention and management of XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient', 'Patient'] @entity712 :: ('MESH:D006333', 'Disease') :: ['congestive heart failure'] @entity19820 :: ('MESH:D058686', 'Disease') :: ['coronary-subclavian steal'] @entity951 :: ('MESH:D000787', 'Disease') :: ['angina'] @entity613 :: ('MESH:D007383', 'Disease') :: ['left arm claudication'] @entity741 :: ('MESH:D017202', 'Disease') :: ['myocardial ischemia'] @entity453 :: ('MESH:D003324', 'Disease') :: ['coronary artery disease'] @entity850 :: ('MESH:D003251', 'Disease') :: ['stenosis'] @entity3526 :: ('MESH:D013349', 'Disease') :: ['SAS', 'subclavian artery stenosis']
@entity19820 :: (MESH:D058686,Disease) :: ['coronary-subclavian steal']
