Angina pectoris associated with coronary-subclavian steal syndrome

case report

Abstract

Coronary-subclavian steal syndrome (CSSS) is a rare cause of myocardial ischemia after myocardial revascularization surgery (0.1% to 6%), with the main etiology being atherosclerosis. CSSS has an incidence of 3% in the population with atherosclerotic disease. The existence of peripheral vascular disease is the best predictive factor for the occurrence of CSSS. Prevalence is difficult to determine as many patients do not experience symptoms due to the development of an additional collateral network. Treatment is centered on correcting subclavian artery stenosis. Over the last decades, endovascular revascularization of subclavian arteries has presented excellent technical success rates (97%) and patency (5-year patency rate of 89–95%), comparable to surgical revascularization, with the advantage of being a minimally invasive technique, with morbidity and mortality rates (4.5%) lower than surgery and associated with shorter hospitalization, as well as faster recovery. We report a case of angina pectoris, in a post-CABG patient, with SRCS as the etiology and how the diagnosis and management of the case were made.