Key result
Novel detachable vascular coil successfully achieves acute occlusion of steal-causing internal mammary artery branches.
Why the study?
Coronary artery steal syndromes after CABG due to large IMA side-branches require effective occlusion methods, but optimal techniques are not established.
Does a detachable vascular embolization coil safely and effectively occlude IMA side-branches causing coronary steal syndrome?
Case Report (n=2)
Does a detachable vascular embolization coil safely and effectively occlude IMA side-branches causing coronary steal syndrome?
A detachable embolization coil can safely occlude IMA side-branches causing coronary steal after CABG, though multiple coils are recommended to prevent delayed recanalization.
May support detachable coils for IMA coronary steal; hypothesis-generating and should not yet change practice.
Coronary artery steal syndromes following coronary artery bypass grafting (CAB) may occur as a result of the presence of large side-branches arising from the internal mammary artery (IMA). We report the first successful deployment of a new detachable vascular embolization coil device to occlude the IMA side-branches in two patients. Optimal positioning is easily obtained with the unique operator-controlled, safety-release protected mechanism of this device. Complete retraction is possible, with safe and efficient removal of the coil even after deployment. This feature was appreciated during one procedure in which the initially selected coil was found to be oversized, requiring immediate removal. Acute thrombo-occlusion of the IMA side-branches in both patients was observed. We conclude that IMA bypass graft side-branches causing coronary steal can be safely and effectively occluded using this new technique. However, due to observed delayed partial recanalization noted on distant follow-up angiography, we recommend placement of multiple coils at the time of initial embolization.
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Eisenhauer et al. (1998) conducted a case report in Coronary artery steal syndrome following coronary artery bypass grafting (n=2). Detachable vascular embolization coil device was evaluated on Acute thrombo-occlusion of the IMA side-branches. A new detachable vascular embolization coil device successfully achieved acute thrombo-occlusion of internal mammary artery side-branches causing coronary steal in two patients.
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