Transradial Primary Angioplasty in a Patient With Congenital Abnormality of the Forearm Circulation and Increased Bleeding Risk

Transradial percutaneous coronary interventions (PCIs) have gained popularity because of reduced vascular complications and increased patient acceptability. However, safety and efficacy of transradial PCI in ST elevation myocardial infarction has been questioned. Anomalous radial artery anatomy is a relatively common cause of transradial PCI failure. The authors describe a case of a primary PCI performed by transradial approach through a very small caliper and tortuous superficial brachioradial artery (a rare variant). The use of miniaturized and hydrophilic apparels allowed procedure success without significant delay. To the authors’ knowledge, this is the first report of a primary PCI performed through an abnormal superficial brachioradial artery with final success.