Screening for subclavian artery stenosis in patients who are candidates for coronary bypass surgery

We prospectively evaluated 59 patients who were deemed candidates for coronary bypass surgery after coronary artery angiography for subclavian artery narrowing, which could compromise the ipsilateral internal thoracic artery graft. Bilateral arm blood pressure (1313) measurements, ausculatation for supraclavicular or cervical bruits, and questioning about cerebrovascular ischemic symptoms were compared to brachiocephalicsubclavian arteriography. One neurologic complication occurred during arteriography. An upper extremity BID difference of greater than or equal to 15 mm Hg identified all patients with greater than or equal to 50% subclavian artery narrowing. We recommend brachiocephalic-subclavian arteriography only in patients with abnormal noninvasive screening for subclavian stenosis, not routinely. (C) 2002 Wiley-Liss, Inc.