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Wrong-way catheter during radial angiogram : An Illustration

July 5, 2024

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The commonest cause* for repeated entry of right radial catheter to descending aorta is not due to any anomaly. Most times,it is just a skewed angle between right brachio-cephalic artery with Aortic arch, that deflects the catheter to the descending aorta . Just make sure, aortic root is entered with a deeply held inspiration.

*Anomalies of the aortic arch, aberrant right subclavian, Kommerell’s diverticulum, vascular ring must be kept in mind.

Wrong-way catheter during radial angiogram : An Illustration 1

Postamble: A true abnormal course

Though, It might appear prudent to avoid the radial route when encountering anomalous subclavian arteries, the reality is different and adventurous. We have acquired great expertise and successful PTCAs have been done through these tortuous vascular highways.

This is a case report from Dr H.S. Isser, Gunjan Garg, from Safdarjung hospital New Delhi.

Wrong-way catheter during radial angiogram : An Illustration 2 — A successful PTCA through arteria lusoria : The right subclavian connect to the descending aorta, distal to the left subclavian at the level of ductus arteriosus. and pass retrotracheal and retroesophageal before reaching right arm. Image source and courtesy: H.S. Isser, Gunjan Garg, Arteria lusoria: A challenge for transradial coronary interventionist, IHJ Cardiovascular Case Reports (CVCR), Volume 4, Issue 1, 2020,

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Fitcoachion

At this moment, I am a doctor and a health blogger. I wrote my first blog post in 2008 about a new symptom I had experienced with my skin. By 2011, I was writing almost weekly about medical topics and had become a contributing writer at fitcoachion.com. It didn't take me long to realize that this was what I wanted to do for the rest of my life. In 2014, I started working as a doctor and have written more than 25,000 words in that capacity. In addition to working as a doctor, I have also worked as a public relations specialist and as an English tutor.