LAUSR

The coronary angiogram was undertaken via the right transradial approach and demonstrated a dominant right coronary artery (RCA), which was occluded just after the ostium (Fig. 1). The left circumflex was a small vessel with mild atherosclerotic disease. There was some distal tapering of the left main stem into an otherwise healthy left anterior descending artery (LAD). Interestingly, there was a huge epicardial collateral to the posterior descending artery (PDA) arising from the LAD and filling virtually the entirety of the RCA (Fig. 2; Supplementary Video 1, Supplemental digital content 1, http://links.lww.com/ MCA/A381; Supplementary Video 2, Supplemental digital content 2, http://links.lww.com/MCA/A382; Supplementary Video 3, Supplemental digital content 3, http://links.lww. com/MCA/A383). There was no obvious discrete point of transition and the lumen diameter appeared to be unchanged throughout. The PDA in itself had some nonflow limiting atheroma at its mid portion.