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  Indian J Med Microbiol
 

Figure 1: Stepwise demonstration of peripheral percutaneous angioplasty of the right brachiocephalic artery stenosis which was eccentric (solid arrow, a) and unfavorable supra-aortic takeoff (dotted curvilinear line, c) from the aortic arch. Initially, a transfemoral approach was used and could cross with coronary 0.014' whisper extra support guidewire using 6-Fr right coronary guide catheter (b). The lesion was dilated using 5.0 mm × 15 mm balloon (b). For the deployment of the stent, we could not negotiate larger 8-Fr guide catheter/delivery sheath (not shown). The transbrachial approach was used to deploy 10 mm × 37 mm balloon-expandable stent across the lesion (dashed arrow, d) under angiographic guidance from the transfemoral right coronary diagnostic catheter (e) and externally placed scalpel handle across the lesion as a radiopaque marker (c-f). Final check angiography showed no residual stenosis with a brisk flow (f)

Figure 1: Stepwise demonstration of peripheral percutaneous angioplasty of the right brachiocephalic artery stenosis which was eccentric (solid arrow, a) and unfavorable supra-aortic takeoff (dotted curvilinear line, c) from the aortic arch. Initially, a transfemoral approach was used and could cross with coronary 0.014' whisper extra support guidewire using 6-Fr right coronary guide catheter (b). The lesion was dilated using 5.0 mm × 15 mm balloon (b). For the deployment of the stent, we could not negotiate larger 8-Fr guide catheter/delivery sheath (not shown). The transbrachial approach was used to deploy 10 mm × 37 mm balloon-expandable stent across the lesion (dashed arrow, d) under angiographic guidance from the transfemoral right coronary diagnostic catheter (e) and externally placed scalpel handle across the lesion as a radiopaque marker (c-f). Final check angiography showed no residual stenosis with a brisk flow (f)