Surgically treated case of complete obstruction of the left main coronary artery caused by Takayasu's arteritis

the flow diversion into the large epicardiaco-phrenic branch l ed to angina on minimal exertion and lack of opacifiCation of the distal IMA and the diagonal branch, with significant reduction in their d iamete rs (Fig. 1). Pat ients with angina caused by a m a m m a r y ar tery steal were usually t rea ted by interrupt ion of the responsible vessel during reoperation, Which requires thoracotomy. 4 In our pa t ien t the epicardiaco-phrenic branch was easily occluded by the introduct ion of a small self-expanding Coil during t ransar ter ia l catheter embolization using a s tandard femoral ar tery approach. A recent case repor t s showed the efficacy of such a technique in the embolization of the intercostal branch of the IMA. Thus t ransar ter ia l catheter embolizat ion has proved to be a safe and efficient method for embolization of undivided branches, resulting in mammary ar tery flow diversion phenomena.