Introduction
The left internal mammary artery (LIMA) is the preferred conduit for coronary artery bypass surgery (CABG). Originating from the left subclavian artery, the LIMA is threatened by proximal subclavian artery stenosis (SAS). Coronary subclavian steal syndrome (CSSS) describes the condition whereby haemodynamically significant proximal SAS results in flow limitation or reversal within the LIMA graft, classically presenting as myocardial ischemia precipitated by upper limb exertion a number of months following CABG and occurs in as many as 6.8% of patients[1].