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. 2016:2016:8079856.
doi: 10.1155/2016/8079856. Epub 2016 Jul 5.

Arteria Lusoria: An Anomalous Finding during Right Transradial Coronary Intervention

David Allen  1 , Hilary Bews  1 , Minh Vo  1 , Malek Kass  1 , Davinder S Jassal  2 , Amir Ravandi  3
Affiliations

Arteria Lusoria: An Anomalous Finding during Right Transradial Coronary Intervention

David Allen et al. Case Rep Cardiol. 2016.

Abstract

Arteria Lusoria or aberrant right subclavian artery (ARSA) is present in 0.6-1.4% of individuals. It typically remains clinically silent and is often discovered during angiographic procedures. The presence of ARSA can make a right transradial approach for coronary angiography and angioplasty technically more difficult. With the use of catheter support, we describe two cases in which a right transradial approach for catheterization was successful in the setting of ARSA. As such, the presence of ARSA does not warrant abandoning a transradial approach for coronary angiography and angioplasty.

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Figures

Figure 1
Figure 1
Angiographic images from Case  1: (A) aortogram of the ascending, transverse, and descending aorta demonstrating the ARSA; (B) anterior-posterior projection demonstrating the characteristic loop of ARSA with the guidewire in the descending aorta; (C) left anterior oblique cranial projection with Judkins left catheter engaging the left main demonstrating an 80% mid LAD coronary artery lesion; (D) the characteristic loop of ARSA; (E) ballooning of the LAD lesion; (F) final result. ARSA, aberrant right subclavian artery; LAD, left anterior descending; RCCA, right common carotid artery; LCCA, left common carotid; LSA, left subclavian artery.
Figure 2
Figure 2
Angiographic images from Case  2: (A) lateral projection showing characteristic loop of ARSA; (B) left anterior oblique view of right coronary artery showing a 90% proximal lesion; (C) with subsequent stenting; (D) right anterior oblique caudal view of left coronaries with a 70% circumflex, 90% OM1, and 70% OM3; (E) final result; (F) A 3D volume rendered imaged from a contrast-enhanced CT angiographic dataset demonstrating vessels arising from the arch in the following order: RCCA, LCCA, LSA, and ARSA. ARSA, aberrant right subclavian artery; OM, obtuse marginal; RCCA, right common carotid artery; LCCA, left common carotid; LSA, left subclavian artery; Asc Ao, ascending aorta; Desc Ao, descending aorta.
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References

    1. Scala C., Leone Roberti Maggiore U., Candiani M., et al. Aberrant right subclavian artery in fetuses with Down syndrome: a systematic review and meta-analysis. Ultrasound in Obstetrics and Gynecology. 2015;46(3):266–276. doi: 10.1002/uog.14774. - DOI - PubMed
    1. Demirkol S., Balta S., Bozlar U., Sari S., Unlu M., Arslan Z. Kommerell diverticulum associated with aberrant left subclavian artery and right-sided aortic arch. European Heart Journal Cardiovascular Imaging. 2013;14(8):p. 764. doi: 10.1093/ehjci/jet020. - DOI - PubMed
    1. Abhaichand R. K., Louvard Y., Gobeil J.-F., Loubeyre C., Lefèvre T., Morice M.-C. The problem of arteria lusoria in right transradial coronary angiography and angioplasty. Catheterization and Cardiovascular Interventions. 2001;54(2):196–201. doi: 10.1002/ccd.1266. - DOI - PubMed
    1. Valsecchi O., Vassileva A., Musumeci G., et al. Failure of transradial approach during coronary interventions: anatomic considerations. Catheterization and Cardiovascular Interventions. 2006;67(6):870–878. doi: 10.1002/ccd.20732. - DOI - PubMed
    1. Kassimis G., Sabharwal N., Patel N., Banning A. Aberrant right subclavian artery hematoma following radial catheterization. JACC: Cardiovascular Interventions. 2013;6(6):636–637. doi: 10.1016/j.jcin.2012.12.133. - DOI - PubMed

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