Restenosis following subclavian artery angioplasty for treatment of coronary-subclavian steal syndrome: definitive treatment with Palmaz-stent placement.

We report a case of progressive angina pectoris 4 years post coronary bypass surgery, in which the left internal mammary artery (LIMA) was grafted to the native left anterior descending coronary artery. The coronary-subclavian steal phenomenon was proven angiographically with retrograde reflux through the LIMA graft into the distal subclavian vessel, downstream from a critical stenosis at the origin of the subclavian artery. After initially successful angioplasty of the ostial subclavian lesion, restenosis and return of angina prompted repeat dilatation and placement of a Palmaz 154-M stent. Follow-up catheterization has demonstrated persistent patency at the stented site and absence of coronary steal.