Key result
Straightening a complex radial loop causes guiding catheter advancement and iatrogenic LMCA dissection.
Why the study?
Radial loops are a common anatomical challenge causing deferral or failure of transradial approach, with uncertainty about loop straightening timing and catheter manipulation.
Case Report (n=1)
No
Awareness of delayed radial loop recoil may avert catheter-induced left main dissection in transradial PCI; case report leaves open optimal preventive strategies.
Radial loops are the most common radial anatomical entity for deferring or failure of transradial approach. Complex loops may not straighten immediately after traversing the loop and may take a few minutes to straighten out. Here, we describe a case of a complex radial artery loop encountered during transradial percutaneous coronary intervention. We furthermore present a literature review and outline tips and techniques to successfully traverse the radial loop.
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Shah et al. (2022) conducted a case report in Unstable angina with complex radial artery loop (n=1). Straightening of radial loop during transradial PCI was evaluated. Attempting to straighten a complex radial loop during transradial percutaneous coronary intervention pushed the guiding catheter into the left main coronary artery, resulting in iatrogenic dissection.
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