This right coronary has a down going course immediately followed by an acute curve. Proximal curve is noticed by overlapping of the vessel portion as depicted by the dark shadow. This is followed by critical narrowing in its mid-segment. About 2cms from the distal end of the lesion right coronary makes an omega curve and there is another critical lesion at the bifurcation of PDA and PLB.

Notice an acute sharp omega bend in the mid-segment of RCA.

6f Judkins right 4cms curve guide catheter is positioned coaxially into the proximal right coronary artery. Choice pt extra support wire has passed through the first acute bend.

Notice how smoothly the wire is negotiating the omega bend.

Note that after crossing the omega bend wire is shown to be progressing towards the straighter portion of the RCA and is heading towards the lesion. After meeting some resistance the guide catheter backs out.

RAO view is interesting. It shows frighteningly ugly spasm like appearance but really speaking these are all pseudo lesions and they generally do not produce any symptoms. These kinds of pseudo lesions are quite common when a stiff wire like choice pt goes through a tortuous artery.

Note that the wire has straightened out all the tortuosities 2.5mm/ 12mm maverick balloon could be easily passed to the distal lesions.

2.5 mm non drug-eluting stent 13 mm in length is shown here going quite smoothly over the wire negotiating all the tortuosities.

Shows good dilatation of the distal lesion at the point of bifurcation of PDA and PLB. There is a slight pinching of the PLB branch. Subsequently straightforward proximal lesion was reassessed after nitroglycerine and did not show clinical stenosis. On removal of the wire from the right coronary. Please note all the pseudo lesions have disappointed.