Elif PEKER, Betül Emine DERİNKUYU, Remzi KARAOĞUZ, Tanzer SANCAK, Çetin ATASOY

Koroner Subklavyan Çalma Sendromu: Rutin Göğüs Tomografisi ile Tanısı, Subklavyan Arter Stentleme ile Perkütan Tedavisi

Bu yazıda son 2 aydır fiziksel aktivite ile ortaya çıkan göğüs ve sol omuz ağrısı tarifleyen 51 yaşındaki kadın hasta sunulmaktadır. Hastamız 1 yıl önce koroner arter bypass ameliyatı geçirmiştir. Şikayetleri üzerine yapılan göğüs tomografisinde ve anjiografik incelemede sol subklavyan arterde darlık saptanmıştır. Sol subklavyan arterdeki darlık düzeyine perkütan translüminal anjioplasti ile stent yerleştirilmiştir. İşlem sonrasında miyokardiyal perfüzyon normale dönmüştür.

Coronary Subclavian Steal Syndrome: Diagnosis by Routine Chest Computed Tomography and Percutaneous Treatment With Subclavia Artery Stenting

The present case is a 51-year-old woman with complaints of chest and left shoulder pain during physical activity for the last two months. She had a coronary artery bypass grafting one year ago. Chest computed tomography and angiographic examination demonstrated significant stenosis onthe left subclavian artery. Percutaneous transluminal angioplasty and stent implantation was successfully achieved to the left subclavian artery, resulted with restoration of myocardial perfusion.

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Demir I, Yilmaz H, Sancaktar O. Coronary subclavian steal syndrome: treatment by stenting of the left subclavian artery. Jpn Heart J 2002;43:79- 84.
Vranic M, Vaughn PL, Lobato AC, et al. Intraoperative subclavian artery stenting to salvage a LIMA graft. Ann Thorac Surg 1999;68:2333-2334.
Tan JW, Johan BA, Cheah FK, et al. Coronary subclavian steal syndrome: a rare cause of acute myocardial infarction. Singapore Med J 2007;48:5-8.
Chavan A, Mügge A, Hohmann C, et al. Recurrent angina pectoris in patients with internal mammary artery to coronary artery bypass: treatment with coil embolization of unligated side branches. Radiology 1996;200:433-436.
Elian D, Gerniak A, Guetta V, et al. Subclavian coronary steal syndrome: an obligatory common fate between subclavian artery, internal mammary graft and coronary circulation. Cardiology 2002;97:175-179.
Douglas P. Braunwald’s heart disease. In: Zipes D, Libby P, Bonow R, Braunwald E, editors. 7th ed. Endovascular treatment of noncoronary obstructive vascular disease; 2005.p. 1474-1477.
Oslen CO, Dunton RF, Maggs PR, et al. Review of the coronary-subclavian steal following internal mammary artery coronary artery by-pass surgery. Ann Thorac Surg 1988;46:675-678.
Wright IA, Laing AD, Buckenham TM. Coronary subclavian steal syndrome: non-invasive imaging and percutaneous repair. Br J Radiol 2004;77:441- 444.
Filippo F, Francesco M, Francesco R, et al. Percutaneous angioplasty and stenting of left subclavian artery lesions for the treatment of patients with concomitant vertebral and coronary subclavian steal syndrome. Cardivasc Intervent Radiol 2006;29:348-353.
Georges NP, Ferreti JA. Percutaneous transluminal angioplasty of subclavian artery occlusion for treatment of coronary subclavian steal. AJR Am J Roentgenol 1993;161:399-400.