Steam-Deformed Judkins-Left Guiding Catheter With Use Of The Guideliner (R) Catheter To Deliver Stents For Anomalous Right Coronary Artery

Objective: Percutaneous coronary intervention for anomalous right coronary artery (RCA) originating from the left coronary cusp is challenging because of our current inability to coaxially engage the guiding catheter.Methods: We report a case of an 88-year-old woman with non-ST segment elevation myocardial infarction, with an anomalous RCA origin. Using either the Judkins-Left catheter or Amplatz-Left catheter was difficult because of RCA ostium tortuosity. Thus, we used steam to deform the Judkins-Left catheter, but back-up support was insufficient to deliver the stent.Results: We used GuideLiner (R), a novel pediatric catheter with rapid exchange/monorail systems, to enhance back-up support.Conclusions: We were able to successfully stent with both the deformed Judkins-Left guiding catheter and GuideLiner (R) for an anomalous RCA origin.