Dissection of Arteria Lusoria during Transradial PCI: A Rare Complication revealed and followed by Multidetector CT

Though the radial artery is an ideal site of access for coronary percutaneous interventions (PCI), anatomical variations may render this procedure more challenging. An aberrant right subclavian artery (arteria lusoria) arising from the descending aorta is an uncommon congenital variant that occurs in about 0.2–1.7% of the population. In such cases, the angulated retroesophageal course of this artery to the descending aorta imposes difficulties in advancing a guide wire to the ascending aorta during right transradial catheterization. Performing angioplasty by the same way becomes also a difficult task, and requires greater perseverance and skills. We present a report of a iatrogenic dissection of the arteria lusoria during right transradial coronary percutaneous intervention evaluated and confirmed by multidetector computed tomography. This imaging modality is useful to assess the severity and extension of the dissection in order to guide the clinical management of this complication.