PMC4008271_01
Coronary angiography showed (a) and (b) native left coronary artery territory similar to previous described and flow reversal in the LIMA graft; (c) patent left radial artery grafted in a intermediary branch; (d) and (e) native right artery territory similar to previous described; (f) saphenous vein graft to posterior descendent artery occluded.
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fig1
Selective left subclavian angiography showed (a) and (b) severe proximal stenosis, with slow distal flow; (c) subtraction angiography showed no lesions in the carotid arteries.
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fig2
Successful ad hoc left main angioplasty, using a drug-eluting stent (Promus Element 4,0 x 12 m).
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fig3
It was performed an ad hoc, left main percutaneous angioplasty, using a drug-eluting stent 4,0/12 mm (Promus Element) without trifurcation involvement, with final angiographic success (Figure 3).
Proximal left subclavian artery angioplasty with a balloon-expanded stent (Invatec Scuba 9.0 x 30 mm:10 atm); maintained vertebral artery flow.
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fig4
In a second procedure it was performed a proximal left subclavian artery angioplasty with a balloon-expanded stent (Invatec Scuba 9.0 x 30 mm:10 atm) (Figure 4).