Optimal coronary evaluation and management of patient with Shepherd's crook right coronary artery

Abstract

Shepherd's crook deformity of right coronary artery is a unique condition of dramatic upturn with a near 180°C switchback turn. It is a challenge for interventionist to perform percutaneous coronary intervention in case of severe tortuous artery with atherosclerosis. Many tips, techniques and devices have been developed to overcome technical issues. We present an interesting case of 64-year-old male with extreme tortuosity of RCA who had difficulty in assessing the lesion characteristics.