I have 4 similar cases in which chest pain persisted at effort and small ischemic area was shown by scintilography. I made closure of the branches using coil embolization with successful angiographic and clinical results.
I think that percutaneous coil embolization is safe and less agresive.
coil embolisation, is successful and helps in relieving symptoms.
I think prevention is important by dissecting the branches high up into the thoracic cavity especially after opening the pleural space.
in my experience it is irrelevant having an open branch in a LIMA graft. blood flow to the coronary arteries goes mainly in diastole and to the systemic branch in systole. i don't think there is a chance for flow steal unless there is a stenotic anastomosis
Dear Aramendi. The problem is not to think or not. This complication is possible and the question is what treatment is the first choice.
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