*It’s a case of 65 year-old man, diabetic who was symptomatic of angina CCS 2, despite medical treatment, with viable and ischemic inferior wall.
*The selective injection of the RCA was very difficult despite the usage of different types of guiding catheter (JR4, AL0.75, AR1, MP). It showed an abnormal take-off of the ostium and the course of the proximal RCA. We had a very diseased proximal segment followed by a “diaphragm like” lesion. The double injection showed competitive flow in the distality from the distal LAD via a tortuous CC 2 epicardial collateral. There wasn’t a significant disease on the left system.
1) What do you think about the origin and the course of the RCA?
2) What do you think about the mechanism of the occlusion?
3) What would be your strategy if you fail antegradely?
