ABSTRACT
The retroesophageal right subclavian artery (arteria lusoria) is one of the anatomical abnormalities encountered by interventional cardiologists who perform right transradial procedures. We report on 11 patients with arteria lusoria in whom 14 right transradial coronary angiography or angioplasty procedures were attempted among a series of 3,730 consecutive right transradial attempts. This abnormality can be easily detected by angiographic visualization, in the anteroposterior projection, of the angle of the catheter when it engages the ascending aorta, and by manual angiography at the ostium of the right subclavian artery. In such a case, catheterization of the ascending aorta may be difficult or even impossible (7.1%). Selective catheterization of both coronary arteries is more difficult, takes longer, and requires more catheters. The Judkins catheters are recommended, although they are seldom used for the left coronary artery via the right radial approach, for both arteries. All catheter exchanges should be performed on long guidewires.
Subject(s)
Angioplasty, Balloon, Coronary , Coronary Angiography , Intraoperative Complications , Myocardial Ischemia/diagnostic imaging , Myocardial Ischemia/therapy , Pulmonary Edema/diagnostic imaging , Pulmonary Edema/therapy , Radial Artery , Subclavian Artery/abnormalities , Aged , Aortography , Female , Humans , Male , Middle Aged , Retrospective Studies , Subclavian Artery/diagnostic imaging , Subclavian Artery/surgeryABSTRACT
Stent supported angioplasty is being performed in an increasing number of patients and, with advances in device technology, more morphologically complex lesions are being treated. In such a setting, it is extremely important to deliver the device to the target lesion. We describe a new technique that allows successful stent delivery in complex right coronary anatomy using the Judkins right guiding catheter. Cathet Cardiovasc Intervent 2001;53:405-409.
