Percutaneous Coronary Intervention for the Anomalous Left Coronary Artery Originating from the Noncoronary Cusp

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Anatomical Variations

Background:

• Anomalous left coronary artery (LCA) originating from the noncoronary cusp (NCC) presents unique challenges for percutaneous coronary intervention (PCI).
• Difficulties in guiding catheter engagement and achieving adequate backup support are common in these anatomical variations.

Purpose of the Study:

• To report the first successful PCI case for an anomalous LCA originating from the NCC.
• To describe the interventional techniques used to overcome procedural challenges.

Main Methods:

• A 69-year-old woman with unstable angina and an anomalous LCA from the NCC underwent PCI.
• Computed tomography (CT) identified diffuse plaque in the left anterior descending (LAD) artery.
• Specialized guiding catheter techniques, including stabilization with an additional wire, were employed.

Main Results:

• Successful engagement of the anomalous LCA was achieved using a straightened Judkins-Left diagnostic catheter.
• A Judkins-Right guiding catheter was used, and stabilization with an extra wire facilitated stent implantation.
• The PCI procedure for the LAD artery plaque was completed successfully.

Conclusions:

• Percutaneous coronary intervention for anomalous LCA originating from the NCC is feasible.
• Innovative techniques for guiding catheter manipulation and support are crucial for successful outcomes.
• This case expands the understanding of managing coronary artery anomalies during PCI.