Introduction
The left internal mammary artery (LIMA) is the preferred conduit for
coronary artery bypass surgery (CABG). Originating from the left
subclavian artery, the LIMA is threatened by proximal subclavian artery
stenosis (SAS). Coronary subclavian steal syndrome (CSSS) describes the
condition whereby haemodynamically significant proximal SAS results in
flow limitation or reversal within the LIMA graft, classically
presenting as myocardial ischemia precipitated by upper limb exertion a
number of months following CABG and occurs in as many as 6.8% of
patients[1].