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Right coronary artery spasm causing ventricular fibrillation and non-ST elevation myocardial infarction following radial artery cannulation
  1. V J Karthikeyan,
  2. U Krishnan,
  3. N D Palmer
  1. Department of Cardiology, Liverpool Heart and Chest Hospital, Liverpool, UK
  1. Correspondence to Dr N D Palmer, Liverpool Heart and Chest Hospital, Liverpool L14 3PE, UK; nick.palmer{at}

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A 42-year-old lady with multiple cardiovascular risk factors and exertional angina was referred for percutaneous coronary intervention to a tight stenosis of her proximal left anterior descending (LAD) coronary artery. The left circumflex (LCX) and right coronary arteries were mildly diseased.

The elective procedure was initiated via a right radial artery approach using a 6F radial sheath (Cook), which proved difficult to advance due to radial artery spasm. A Q4 guide catheter (Boston Scientific) …

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