Journal of JCIC

A 1-year-old patient with complete atrioventricular septal defect, hypoplastic right ventricle, pulmonary stenosis, aortic overriding, and persistent fifth aortic arch underwent transcatheter coil embolization for aortopulmonary collateral arteries after bidirectional Glenn anastomosis. Access of a catheter from the femoral artery was required for an up-and-down course through the descending aorta, low-positioned persistent fifth aortic arch, solely originated right subclavian artery, and steeply curved right internal thoracic artery. A Judkins right catheter concomitant with a guidewire was unable to proceed to the right internal thoracic artery from the right subclavian artery. A conventional non-steerable microcatheter even combined with a tip-curled guidewire was also unachievable for the navigation to the target artery. Steerable microcatheter with a guidewire could easily navigate into the right internal thoracic artery. Subsequently the steerable microcatheter acted as a guide, and the Judkins right catheter was smoothly inserted to the artery. The patient safely underwent coil embolization by using the steerable microcatheter with the stably-positioned Judkins right catheter.

Steerable microcatheter will enable the navigation to target vessels which is previously thought to be difficult to navigate, and will contribute to reduction of the time and X-ray exposure required for an interventional procedure. Application of steerable microcatheter to a wide variety of usages is expected.