Subclavian artery angioplasty for the treatment of angina using a double balloon technique to protect a left internal mammary artery graft.

Percutaneous transluminal angioplasty (PTA) has proven to be a safe and effective method of treating subclavian stenosis with technical success rates ranging from 83 to 100%. This technique, however, can result in distal embolisation. In the presence of a previous internal mammary bypass graft this may prove catastrophic, especially when that graft provides the dominant supply to the heart. Clearly any technique of reducing the risk of graft embolisation is valuable in this small subgroup of patients. The deployment of a double balloon to protect the left internal mammary artery graft to prevent this potentially fatal event has not been described previously.