Interventions in Left Internal Mammary Artery

Left internal mammary artery (LIMA) grafts are the preferred arterial grafts as they are more durable. LIMA grafts can develop stenosis most commonly at the distal anastomotic site and less frequently involve the ostium or body of LIMA. They may occur in the immediate post-operative period due to technical faults or occur several years later. LIMA graft interventions are more challenging because of its long and tortuous course and frequently tend to develop spasm and dissection. It might be the only method of revascularization in some patients and needs to be undertaken on and off. LIMA grafts have been used for retrograde revascularization of chronic total occlusion of native coronary arteries.