Key result
Percutaneous coronary intervention with a drug-eluting stent successfully treated a rare acute thrombotic occlusion of a right internal mammary artery graft in a 72-year-old female.
Why the study?
RIMA or LIMA graft occlusion occurs in only a fraction of patients, and mid-graft lesions presumed secondary to atherosclerosis are particularly rare.
Case Report (n=1)
This case highlights the rare occurrence of an acute thrombotic occlusion of a right internal mammary artery (RIMA) graft, likely mediated by atherosclerosis, and its successful treatment with percutaneous coronary intervention.
Successful PCI with DES for rare RIMA graft thrombosis adds to limited reports; hypothesis-generating for incidence and management.
Patients who present with acute myocardial infarction are often urgently evaluated for possible revascularization via coronary artery bypass graft surgery (CABG), percutaneous coronary intervention (PCI), or medical therapy alone. CABG has been shown to provide symptomatic relief as well as increased long-term survival for patients with multivessel coronary artery disease (CAD). Though venous grafts can be used to revascularize the ischemic territory, long-term patency is most successful when using pedicled coronary grafts such as the left internal mammary artery (LIMA) or right internal mammary artery (RIMA) graft. Only a fraction of patients who undergo a RIMA or LIMA will occlude their graft, and mid-graft lesions presumed secondary to atherosclerosis are even rare. For our case report, we evaluate a 72-year-old female who has had a very rare acute coronary occlusion of her mid-RIMA graft resulting in an acute apical left ventricular infarct. A heart catheterization confirmed a 100% thrombotic occlusion of the mid-RIMA-LAD, which was stented with a 2.5 x 20 mm drug-eluting stent.
No takes yet. Share an insight, caveat, or question.
Abubaker et al. (2022) conducted a case report in Right internal mammary artery graft occlusion (n=1). Percutaneous coronary intervention with drug-eluting stent was evaluated on Successful revascularization and symptom resolution. Percutaneous coronary intervention with a drug-eluting stent successfully treated a rare acute thrombotic occlusion of a right internal mammary artery graft in a 72-year-old female.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: