Consideration of the Femoral Artery Approachin Percutaneous Coronary Intervention of Acute St-Segment Elevation Myocardial Infarction in Kommerell’s Diverticulum With A Right-Sided Aortic Arch: A Case Report

Owing to vascular malformations, it is difficult to perform catheter operation following the radial artery approach in percutaneous coronary intervention for acute ST-segment elevation myocardial infarction (STEMI) with Kommerell’s diverticulum on the right-sided aortic arch. However, only few studies have reported the use of the femoral artery approach to achieve early reperfusion; however, there is no established approach for patients with a right-sided aortic arch. In this study, we retrospectively analyzed the usefulness of the femoral artery approach in patients with STEMI and a right-sided aorta from January 2010 to March 2021.The total number of computed tomography (CT) cases was 180,514, of which 2 involved STEMI. In one of the two cases, the right radial artery approach was used. Therefore, only one patient with STEMI with a right-sided aortic arch underwent and operation using the femoral artery approach. In this patient, early revascularization was achieved with a door-to-balloon time of 70 min, suggesting the usefulness of the femoral artery approach.