Recurrent angina pectoris in patients with internal mammary artery to coronary artery bypass: treatment with coil embolization of unligated side branches.

ABSTRACT

PURPOSE: The purpose of the study was to evaluate the effect on the symptoms of transcatheter coil embolization of branches of the internal mammary artery. MATERIALS AND METHODS: In five patients with coronary steal syndrome that was caused by preferential flow in large unligated side branches of the internal mammary artery, coil embolization of the side branches was performed with use of a coaxial microcatheter. RESULTS: Anginal symptoms disappeared in three patients and were substantially reduced in one patient following the radiologic intervention. In the fifth patient, who had concomitant stenoses of other coronary vessels, only a moderate change in symptoms was noted. No complications occurred. CONCLUSION: In patients with internal mammary artery to coronary artery bypass who experience recurrent angina pectoris caused by preferential flow in large, unligated side branches of the internal mammary artery, repeat surgery may be circumvented or simplified by transcatheter coil embolization, which can help treat the angina.