Limb Ischemia Due to Use of Internal Thoracic Artery in Coronary Bypass

I refer to the article reported by Yapici et al in the Asian Cardiovascular and Thoracic Annals, entitled “Limb Ischemia Due to Use of Internal Thoracic Artery in Coronary Bypass.”1 They presented two patients with left lower leg ischemia that developed after left internal thoracic artery (ITA) grafting. They recommended the assessment of epigastric arterial flow by doppler ultrasound and the examination of the abdominal aorta and iliac artery by angiography if aortoiliac occlusion is suspected. They also suggested the use of pulse oximetery or digital examination of the foot before ITA harvest.