Left internal mammary artery (LIMA) angiography is often done after coronary angiography to document patency of the LIMA when coronary artery bypass grafting is contemplated. LIMA angiography is also done while evaluating post coronary artery bypass cases to study the graft patency. LIMA angiography is also useful to demonstrates collaterals to the descending aorta in cases of post subclavian aortic occlusion. In this case branches of superior epigastric artery, a branch of the LIMA anastamoses with branches of the inferior epigastric artery which arises below the occlusion.

If the LIMA is rejected as graft for CABG, will the right IMA
be used? What is the rationale for preference for the LIMA?
Thanks
LIMA is generally easier to harvest and graft being on the left side. The length of RIMA is often insufficient for an in situ grafting. Radial artery may have to be attached. RIMA is generally smaller than LIMA and in most cases when LIMA is small, RIMA will also be small (Source: cardiac surgeon of our hospital).
There are centres which use both LIMA and RIMA for total arterial revascularisation. Bilateral internal mammary grafts can sometimes delay sternal wound healing.