Colegio Argentino de Cardioangiólogos Intervencionistas Revista Argentina de Cardioangiología intervencionista 2250-7531 2313-9307 16 2 2025 06 30 Coronary flow steal from an unligated pectoral branch during myocardial revascularization and its endovascular treatment 0074 0076 EN Natali Zingoni Hospital Militar Central “Cirujano Mayor Dr. Cosme Argerich”, CABA, Argentina medicinavascular@yahoo.com.ar; zingoninatali@gmail.com Juan Raimondo Hospital Militar Central “Cirujano Mayor Dr. Cosme Argerich”, CABA, Argentina Ildigardo Castillo Hospital Militar Central “Cirujano Mayor Dr. Cosme Argerich”, CABA, Argentina Oscar Carlevaro Hospital Militar Central “Cirujano Mayor Dr. Cosme Argerich”, CABA, Argentina We present the case of a patient who underwent myocardial revascularization surgery. Six months after the procedure, he presented with exertional angina and non-sustained ventricular tachycardia. Cardiac catheterization revealed a patent left internal mammary artery (LIMA) graft, but with a high unligated pectoral branch, thus causing flow steal. Selective endovascular embolization of the branch successfully restored the coronary flow. The patient had a favorable outcome, with no symptom recurrence during follow-up. This case highlights the importance of complete skeletonization of the LIMA during surgery and postoperative clinical follow-up in symptomatic patients. myocardial revascularization, internal mammary artery, embolization, coronary steal, diabetes mellitus http://www.raci.com.ar/contenido/art.php?recordID=Mjk0NQ== http://recursos.meducatium.com.ar/contenido/articulos/37200740076_2945/pdf/37200740076.pdf