Right Internal Mammary Artery Steal Syndrome: Successful Percutaneous Coil Embolization of a Collateral Branch. Case report

Abstract Background Case Coronary artery bypass grafting (CABG) is a common revascularization strategy, yet ischemic symptoms may persist despite patent grafts. Case Summary We describe a 60-year-old man with three-vessel coronary artery disease treated with triple CABG who presented with persistent dyspnea and infero-lateral myocardial hypoperfusion. Repeat coronary angiography demonstrated patent grafts but identified a collateral branch of the right internal mammary artery causing a steal phenomenon. Coil embolization of the collateral vessel led to complete symptom resolution and normalization of myocardial perfusion. Discussion This case highlights a rare cause of CABG steal syndrome and emphasizes the need for careful assessment of internal mammary artery branches in patients with ongoing post-CABG ischemia