Ultra Long Stent in an Aberrant Right Coronary Artery
Desabandhu Vinayakumar1, Jomy Vadasseril Jose1
1Department of Cardiology, Government Medical College, Kozhikode, Kerala, 673008, India.
Insights
Percutaneous coronary intervention (PCI) for anomalous right coronary artery (RCA) originating from the left sinus is challenging. This case reports the successful stenting of a long lesion in an aberrant RCA, a novel procedure.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Medicine
Background:
- Anomalous origin of the right coronary artery from the left aortic sinus (ALCAPA) is a rare congenital coronary artery anomaly.
- Percutaneous coronary intervention (PCI) in aberrant coronary arteries presents unique technical challenges due to complex anatomy.
- The prevalence of RCA originating from the left sinus is approximately 0.92%.
Observation:
- A 75-year-old female presented with acute coronary syndrome.
- Coronary angiography revealed significant lesions in the left anterior descending and left circumflex arteries.
- An aberrant right coronary artery (RCA) originating from the left sinus, near the left main coronary artery (LMCA), exhibited multiple tight stenoses.
Findings:
- Successful PCI was performed on the aberrant RCA.
- A 50 mm long stent was deployed in the anomalous RCA, addressing extensive lesions.
- This represents the first reported instance of successfully placing such a long stent in an aberrant coronary artery.
Implications:
- This case demonstrates the feasibility of complex PCI in rare coronary anomalies.
- Advanced techniques may enable effective treatment for patients with aberrant coronary arteries and significant lesions.
- Further research into interventional strategies for anomalous coronary arteries is warranted.
Abstract:
The prevalence of anomalous origin of right coronary artery from the left sinus is about 0.92%. A percutaneous coronary intervention (PCI) in such a vessel is challenging especially when maneuvering long stents. We report a case of 75-year old female patient with recent acute coronary syndrome. The angiogram showed significant lesions in the left anterior descending coronary artery and the left circumflex coronary artery with an aberrant RCA originating from the left sinus close to the origin of LMCA with multiple tight lesions. The aberrant RCA was stented with a 50 mm long stent. To the best of our knowledge, the placement of such a long stent in an aberrant coronary artery has hitherto never been reported in the literature.
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