PMC8086675_01
Inserted 5 French sheath via snuffbox approach.
cardj-26-3-292f1.jpg
PMC8086675_01_cardj-26-3-292f1.jpg
f1-cardj-26-3-292
This was successfully cannulated by a 5 French sheath (Fig. 1).
A. Peripheral angiography demonstrating the left brachial artery anomaly; B. Angiographic assessment demonstrating multiple linear filling defects and haziness in the proximal coronary artery; C, D. Longitudinal and cross-sectional optical coherence tomography imaging demonstrated a honeycomb-like structure with multiple cavities of various sizes; E. Final angiogram demonstrated good distal flow without residual stenosis from treatment with 2.75 x 38 mm Xience Sierra  stent.
cardj-26-3-292f2.jpg
PMC8086675_01_cardj-26-3-292f2.jpg
f2-cardj-26-3-292
However, brachial artery anomaly led to a change in the access site using the right snuffbox approach (Fig. 2A). Coronary angiography demonstrated diffuse stenosis with multiple linear filling defects and haziness in the proximal right coronary artery (Fig. 2B). Optical coherence tomography (OCT) showed a honeycomb-like structure with multiple cavities and it was concluded that this represented recanalized thrombus (Fig. 2C, D, Suppl. Final coronary angiography showed good distal flow without residual stenosis (Fig. 2E).