Right internal mammary artery graft angioplasty through a right brachial artery approach using a new custom guide catheter: A case report

Angioplasty of the internal thoracic artery bypass-graft an alternative to reoperation

BACKGROUND

This review presents an overview of interventional revascularization procedures of the internal thoracic artery after prior implantation as a coronary-artery bypass graft.

METHODS

Our search was concentrated on the MEDLINE-database to identify all articles on internal thoracic artery-graft-angioplasties and reoperation after internal thoracic artery bypass grafting published between 1968 and 2000.

RESULTS

Surgical revascularization and reoperation were reported in five papers including a total of 785 patients. The overall mortality of these patients was 4.2%. The presence of a patent internal thoracic artery-graft at the time of reoperation was not a risk factor for higher morbidity and mortality. Revascularization with percutaneous transluminal coronary angioplasty of the internal thoracic artery or the native left anterior descending artery via the internal thoracic artery-graft used as a conduit was performed in 327 patients. The primary success rate was 87%, the angiographically assessed rate of restenosis was 30% and the rate of complications approximately 1%.

CONCLUSIONS

In spite of technical problems the percutaneous transluminal coronary angioplasty in or via internal thoracic artery-graft presents a safe and feasible option to be recognized before a potential reoperation.

Bilateral internal mammary angiography through a right radial approach: a case report

This case report demonstrates that bilateral internal mammary angiography through a single right-radial approach is feasible and convenient. It avoids double-brachial or radial artery puncture, is adapted to the variable characteristics of right internal mammary artery origin, and may be considered when the femoral approach is contraindicated.