Conclusion. Thus, the patient

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Headache syndrome subclavian ARTICLES - coronary steal in patients solvent after mammary - coronary bypass COMBINED WITH SYNDROME subclavian - CEREBRAL steal and stenosis of the right renal artery.
Subclavian SYNDROME - coronary steal in patients after mammary - coronary bypass COMBINED WITH SYNDROME subclavian - CEREBRAL steal and stenosis of the right renal artery.
Introduction. The incidence of subclavian solvent steal syndrome (PPS) in the population (EU) is about 1.3% [1-2, 13] Among those with neurological symptoms solvent undergoing Doppler study of head and neck vessels incidence of this disease is approximately 17% [2, 13]. Basically pathology manifested symptoms of vertebral-basilar insufficiency (dizziness, syncope attacks are possible blurred vision, muscle weakness in the limbs on the affected side, the absence solvent or weakening of the pulse on the affected side, other signs of acute or chronic circulatory disorders of the upper limb). Stroke as a complication of open source software with intact carotid arteries is rare [12, 13]. Patients undergoing solvent mammary artery bypass grafting, solvent celebrate the return of angina symptoms [3-12].
Clinical data. Patient T., 63 years old, suffered a Q - IM in 1996, CABG-3, UGS-1 (LAD) in 2004, within solvent a few months has been a steady increase in SBP 170-180 mm Hg to no response to antihypertensive solvent drugs, recovery and growth of angina symptoms, dizzy spells, periodic loss of consciousness, paresthesia and pain in the left upper limb during physical exertion. In a study of the difference in SBP of 40 mm Hg upper limbs, electrocardiogram (6.03.09): Atrial fibrillation is a heart rate of 80-120 min, subendocardial ischemia, focal cardio on the rear wall of the left ventricle. Echocardiography (3/6/09): EDV - 128 ml., EF - 51%, MND - 2+ TKNd - 1+, PL - 5.2 cm. Hypokinesia low back wall of the left ventricle in the basal parts of the transition to the middle. 6.03.09 performed coronary ventriculography, shuntografiya, aortography abdominal aorta, left subclavian artery angiography: Stenosis of the left main OS 85% stenosis of LAD 85%. Subokklyuziya PKA over the proximal and middle segments. Shunts on RCA and LAD (a. Mammaria) passable. Subokklyuziya distal anastomosis shunt to VTK-1 OB LCA. Stenosis of the right renal artery 65%. Stenosis of the left subclavian artery 80%. In one session with CVG performed PCA subokklyuzii distal anastomosis solvent on VTK - 1 OB LCA. 10.03.09 routinely by standard methods after balloon predilatation 2.0 15 mm stenting OS LCA stent Endeavor Resolute solvent 3.0 15. Further, as in the conventional way in the proximal left subclavian artery stent OmniLink 8.0 28, with the proximal part of the stent postdilatatsiey to 8.3 mm. Further, according to standard procedures in the right renal artery stent HercuLink 6.5 12. The final result is good. In the perioperative period, patients received standard antiplatelet therapy as recommended solvent by ACC / AHA. 12.03.09 in satisfactory condition the patient was discharged under the supervision of a cardiologist on a residence.
Conclusion. Thus, the patient's syndrome has been a combination of subclavian-cerebral solvent and coronary-subclavian steal co renal artery stenosis. Simultaneous coronary stenting, subclavian and renal arteries significantly improved the condition and quality