Internal mammary artery and inferior epigastric artery collateralization in a patient with aortoiliac occlusive disease
Abstract
vmjVascular Medicine1358-863X10.1177/1358863X0809859508098595Images in vascular medicineInternal mammary artery and inferior epigastric artery collateralization in a patient with aortoiliac occlusive diseaseIMA and IEA collateralization in aortoiliac occlusive diseaseKolluriRaghu12HollowayRichard2MishkelGregory121Prairie Vascular Institute, Springfield, Illinois, USA2Prairie Cardiovascular Consultants, Springfield, Illinois, USACorrespondence to: Raghu Kolluri, Prairie Vascular Institute, 401 East Carpenter St, Springfield, IL 62702, USA. Email: Rkolluri@prairieheart.com010220091419394SAGE Publications2009A 69-year-old female with a history of coronary artery disease, smoking, stenosis of the distal aorta, and squamous cell carcinoma of the tongue was referred for pre-operative cardiovascular clearance for jaw reconstruction surgery. She complained of lifestyle-limiting bilateral hip, buttock, thigh, and calf claudication, with an initial claudication distance of one-half city block and an absolute claudication distance of one city block. Her ankle brachial index (ABI) was noted to be 0.36 on the right leg and 0.43 on the left leg. Segmental pressures and pulse volume recordings suggested disease at the aortoiliac segment. A CT angiogram demonstrated aortic occlusion, collateralization between the internal mammary arteries (IMA) and inferior epigastric arteries (IEA), and reconstitution of the infra-inguinal vessels bilaterally (Panels A and B; CFA = common femoral artery). The patient underwent cardiac catheterization due to significant ischemia on a dipyridamole tomographic dual isotope scan. A selective