Torsion of an internal mammary graft during percutaneous transluminal angioplasty: a case report.

A successful percutaneous transluminal angioplasty of the distal anastomosis of a tortuous left internal mammary artery graft to the left anterior descending coronary artery was complicated by the development of a focal lesion in the mid-graft region. Dilatation at the site failed to improve the angiographic appearance. Withdrawal of the guidewire resulted in immediate resolution of the apparent mid-graft lesion. The abnormality is felt to have been due to torsion of the graft upon itself, caused by guidewire and balloon catheter manipulation.