Left subclavian (green arrow) angiogram by trans-radial route using tiger catheter (blue arrow). Left subclavian angiogram is usually taken towards the end of coronary angiography procedure when multivessel disease or left main coronary artery disease requiring coronary artery bypass grafting is documented. This is in order to visualize the left internal mammary artery (LIMA) to be used for bypass grafting. This is an early frame so that the LIMA is not clearly seen. Vertebral artery is faintly seen arising from the left subclavian, at the upper part of the image (black arrow). In femoral approach, catheter can be pushed further to cannulate the LIMA directly. Special catheter for cannulating the LIMA are also available. The person may experience discomfort in the chest during a LIMA injection, especially with the older ionic contrast agents.
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