Iatrogenic aortic dissection following transradial coronary angiography in a patient with an aberrant right subclavian artery

An aberrant right subclavian artery is a congenital aortic arch anomaly in which the right subclavian artery originates from the proximal descending aorta. The presence of an aberrant right subclavian artery can make right transradial coronary interventions more difficult and even lead to complications. Iatrogenic intramural hematomas and dissection of aberrant right subclavian arteries during transradial coronary angiography have been previously reported. We herein report a case of iatrogenic aortic dissection following attempts to perform right transradial coronary angiography in a patient with an aberrant right subclavian artery. Clinicians should be vigilant for the presence of an aberrant right subclavian artery during right transradial coronary angiography and ensure gentle manipulation of wires and catheters to avoid complications.