CORONARY-SUBCLAVIAN STEAL SYNDROME, TREATED BY BALOON-EXPANDABLE PERIPHERAL STENT. CASE REPORT

A. V. Sapunov, I.Y. Sagatov I.Y., B. Ormanov, Ye. Ye. Abilkhanov
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Abstract

Patient K., male smoker, 65 years old, suffering from type 2 diabetes, adhering to basic therapy, in year 2018 underwent isolated internal mammary bypass surgery for coronary artery disease. In 2022, due to a deterioration in general well-being in the form of stabbing pains behind the sternum, shortness of breath during physical exertion, pain and numbness of the left upper limb, he was scheduled for coronary angiography with shuntography. During routine shuntography through the left radial access, the presence of retrograde filling of the LIMA graft was established, indicating the presence of the phenomenon of coronary-subclavian steal. Elimination of hemodynamically significant stenosis of the left subclavian artery with a peripheral balloon-expandable stent led to successful remodeling of left coronary hemodynamics, relief of angina symptoms, and restoration of adequate blood flow in the left upper limb in the early postoperative period.
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冠状动脉-锁骨下窃血综合征,气囊扩张外周支架治疗。病例报告
患者K.,男性吸烟者,65岁,患有2型糖尿病,坚持基础治疗,于2018年因冠状动脉疾病接受了孤立性乳房内搭桥手术。2022年,由于总体健康状况恶化,表现为胸骨后刺痛、体力消耗时呼吸急促、左上肢疼痛和麻木,他被安排进行冠状动脉造影和分流术。在通过左桡骨通道的常规分流术中,发现LIMA移植物存在逆行充盈,表明存在冠状-锁骨下窃血现象。外周球囊可扩张支架消除左锁骨下动脉血流动力学显著狭窄,成功重塑左冠状动脉血流动力学,缓解心绞痛症状,术后早期恢复左上肢血流充足。
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