Korean Circ J.  2012 Dec;42(12):866-868. 10.4070/kcj.2012.42.12.866.

Sudden Cardiac Arrest with Acute Myocardial Infarction Induced by Left Subclavian Artery Occlusion in a Patient with Prior Coronary Artery Bypass Surgery

• Won KB
• Cho YH
• Cho DK

• KMID: 1491106
• DOI: http://doi.org/10.4070/kcj.2012.42.12.866

Abstract

Multivascular preventive and therapeutic approaches are necessary in patients with coronary artery disease because atherosclerosis has a common systemic pathogenesis. We present a rare case of sudden cardiac arrest with acute myocardial infarction induced by the total occlusion of left subclavian artery (LSCA) in a patient with a history of previous coronary artery bypass surgery using the left internal mammary artery. We initially performed blind-puncture of left brachial artery, attempting percutaneous coronary intervention because pulses were absent in both upper and lower extremities. However, the cause of sudden cardiac arrest was atherosclerotic total occlusion of LSCA. The patient was stabilized after successful revascularization of LSCA by percutaneous transluminal angioplasty with stent insertion.

Keyword

Sudden cardiac arrest; Coronary artery bypass surgery; Atherosclerosis

MeSH Terms

Angioplasty
Atherosclerosis
Brachial Artery
Coronary Artery Bypass
Coronary Artery Disease
Coronary Vessels
Death, Sudden, Cardiac
Humans
Lower Extremity
Mammary Arteries
Myocardial Infarction
Percutaneous Coronary Intervention
Stents
Subclavian Artery

Figure

• 

  Fig. 1 Transbrachial peripheral angiography demonstrates (A) total occlusion of left subclavian artery (LSCA) (arrow) with patent graft from left internal mammary artery to mid left anterior descending artery, (B) balloon angioplasty of LSCA (arrow), (C) successful revascularization with stent insertion at LSCA (arrow).

• 

  Fig. 2 Transbrachial peripheral angiography demonstrates (A) total occlusion of left subclavian artery (LSCA) (arrow) with patent graft from left internal mammary artery to mid left anterior descending artery, (B) balloon angioplasty of LSCA (arrow), (C) successful revascularization with stent insertion at LSCA (arrow).

• 

  Fig. 3 Transbrachial peripheral angiography demonstrates total occlusion of right common iliac artery (arrow) and left external iliac artery (arrowhead).

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