title: Steam-deformed Judkins-left guiding catheter with use of the GuideLiner(®) catheter to deliver stents for anomalous right coronary artery.
abstract: OBJECTIVE
  Percutaneous coronary intervention for anomalous right coronary artery (RCA) originating from the left coronary cusp is challenging because of our current inability to coaxially engage the guiding catheter.
  
  
  METHODS
  We report a case of an 88-year-old woman with non-ST segment elevation myocardial infarction, with an anomalous RCA origin. Using either the Judkins-Left catheter or Amplatz-Left catheter was difficult because of RCA ostium tortuosity. Thus, we used steam to deform the Judkins-Left catheter, but back-up support was insufficient to deliver the stent.
  
  
  RESULTS
  We used GuideLiner®, a novel pediatric catheter with rapid exchange/monorail systems, to enhance back-up support.
  
  
  CONCLUSIONS
  We were able to successfully stent with both the deformed Judkins-Left guiding catheter and GuideLiner® for an anomalous RCA origin.
authors.affiliation: Department of Cardiology, Ashikaga Red Cross Hospital, Ashikaga-shi, Japan.
authors.forename: Toshiki
authors.initials: T
authors.lastname: Kuno
authors.affiliation: Department of Cardiology, Ashikaga Red Cross Hospital, Ashikaga-shi, Japan.
authors.forename: Taishi
authors.initials: T
authors.lastname: Fujisawa
authors.affiliation: Department of Cardiology, Ashikaga Red Cross Hospital, Ashikaga-shi, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yamazaki
authors.affiliation: Department of Cardiology, Ashikaga Red Cross Hospital, Ashikaga-shi, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Motoda
authors.affiliation: Department of Cardiology, Ashikaga Red Cross Hospital, Ashikaga-shi, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Kodaira
authors.affiliation: Department of Cardiology, Ashikaga Red Cross Hospital, Ashikaga-shi, Japan.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Numasawa
keywords: Anomaly; myocardial infarction; percutaneous coronary intervention