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Culotte PCI through Arteria Lusoria

Aberrant!!right!!subclavian!!artery!! (ARSA)!!or!!arteria!!lusoria!! is!one!of!the!most!common!congenital!aortic!arch!anom a- ly!!with!!prevalence!!ranging!!from!!1-2%!![1- 3].!!However, !!it!!is!! mostly!asymptomatic!and!consequently!often!found!spor ad- ically!during!various!diagnostic!procedures!with!prev alence! of!0.45%!during!coronary!angiography! [4].!We!report!a!case! of!a!67-year- old!male!with!bifurcation!stenosis!of!proximal! left!!anterior!!descending!!artery!!and!!first!!diago nal!!branch! (Medina!!1, 0, 1).!!We!!performed!!an!!elective!!percutaneous!! coronary!intervention! (PCI)!using!specific!culotte!stenting! technique!!using!!right!!transradial!!access!!through !!ARSA.!! To!the!authors!best!knowledge, !this!is!the!first!described! case!of!PCI!of!the!bifurcation!stenosis!via!the!ARSA. !Sub- sequent!!64- slice!!computed!!tomography!!angiography!!con- firmed!the!angiographic!findings!of!ARSA.!Although!pe rcu- taneous!coronary!intervention, !especially!of!the!bifurcation! stenosis, !is!difficult!to!perform!using!transradial!approach! through!!ARSA, !!the!!procedure!!could!!be!!done!!successfully!! in!high- volume!PCI!centres!dedicated!to!transradial!access.!

Aberrant!right!subclavian!artery, !Bifurcation, !Culotte, !Stent- ing, !Transradial, !Access

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