Case Report: When crossing is not enough: restoring functional access in an extreme brachial artery loop during primary PCI - Takeaways - MDSpire

Case Report: When crossing is not enough: restoring functional access in an extreme brachial artery loop during primary PCI

  • By

  • Ali Hakan Konuş

  • Recep Polat

  • July 16, 2026

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  • 1

    A 73-year-old woman with acute inferior ST-elevation myocardial infarction underwent primary PCI via right radial access.

  • 2

    The case involved extreme upper-limb arterial tortuosity with a near-complete circular brachial artery loop.

  • 3

    Successful guidewire traversal did not achieve functional access due to failure of geometric correction.

  • 4

    A structured escalation strategy using progressively higher-support guidewires restored functional access.

  • 5

    The case emphasizes the need to distinguish between traversal success and effective catheter performance in PCI.

Original Source(s)

Case Report: When crossing is not enough: restoring functional access in an extreme brachial artery loop during primary PCI

  • by Ali Hakan Konuş, Recep Polat

  • July 16, 2026

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