Giuseppe Vadalà, Vincenzo Sucato, Chiara Alaimo, Giuseppe Roscitano, Alfredo Ruggero Galassi
Interrupted Aortic Arch (IAA) is a rare congenital abnormality characterized by a complete discontinuity of the aortic lumen, usually located after the origin of the left subclavian artery. IAA is mainly diagnosed during childhood and has an extremely high mortality rate if left untreated. Therefore, only a few cases have been diagnosed in adulthood. We report the case of a patient with Non-ST Segment Elevation Myocardial Infarction (NSTEMI) and unknown IAA abnormality, who underwent urgent percutaneous coronary angioplasty (PCI). It was not possible to reach ascending aorta from the right radial artery because of the presence of tangled arteries connecting the pre-vertebral subclavian segment to the descending aorta. PCI was completed successfully through the left radial artery. A post-procedural Angio-CT scan confirmed the Aortic Arch interruption. The presented case highlights the crucial role of a multi-imaging modality approach for those patients with such congenital abnormalities before undergoing PCI.