Left anterior descending artery percutaneous coronary intervention from the right radial access via the left internal mammary artery: a case report

BackgroundTrans-radial access in coronary intervention has gained popularity as it grants advantages in patients with higher risk of haemorrhage, especially those with non-cardiac conditions and those treated with oral anticoagulant therapy.Case reportWe report a case of percutaneous coronary intervention (PCI) of the left anterior descending (LAD) artery distal to left internal mammary artery (LIMA) anastomosis from the usually contraindicated right radial approach, in an actively bleeding patient affected by gastric cancer and chronic atrial fibrillation, and with no other available low-risk route.ConclusionLAD trans-LIMA PCI via right radial access can be attempted in selected cases with suitable anatomy.