ArticleJACC. Case reports2026
Bailout Access to an Anomalous-Origin Occluded Right Coronary Artery Using Anchor Wire Stabilization in Cardiogenic Shock.
Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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3 authors.
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Abstract
objectiveTo present a reproducible bailout technique using anchor wire stabilization in the left anterior descending artery for accessing aorto-ostial right coronary artery (RCA) occlusion with anomalous origin in inferior-right ventricular ST-segment elevation myocardial infarction (STEMI) complicated by cardiogenic shock. KEY STEPS: 1) Anchor a 6-F Amplatz left 1.0 guiding catheter in the left coronary system with a Sion guidewire for stability. 2) Perform controlled clockwise rotation and probing of the aortic root using a Runthrough guidewire to cross the occluded anomalous RCA ostium. 3) Perform balloon angioplasty followed by stent implantation to achieve TIMI flow grade 3 and hemodynamic stabilization. POTENTIAL PITFALLS: The Amplatz left catheter and/or stiffer wires could jeopardize the aortic root and coronary ostium. Early aortography is recommended if the RCA appears "absent" on nonselective injections to detect ostial occlusion and/or anomalies. TAKE-HOME MESSAGES: Acute aorto-ostial occlusion of an anomalous RCA may cause inferior-right ventricular STEMI and apparent angiographic "absence". This anchor-assisted probing maneuver offers a safe, effective bailout strategy for difficult coronary access in unstable patients.
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