A Difficult Route for Percutaneous Coronary Intervention: Single Coronary Artery Anomaly

Area of Science:

• Cardiology
• Interventional Cardiology
• Vascular Biology

Background:

• Coronary artery anomalies (CAA) are often asymptomatic but carry variable prognoses.
• Single coronary artery anomaly is a rare variant with limited published data.
• The anomalous artery's course is a key prognostic determinant.

Observation:

• Percutaneous revascularization in anomalous coronary arteries is technically demanding.
• A case of single coronary artery anomaly with myocardial infarction is presented.
• An alternative technique involving guidewire advancement into the anomalous left main coronary artery was employed.

Findings:

• Successful percutaneous revascularization of a culprit lesion in the left anterior descending artery was achieved.
• The alternative technique facilitated crossing the complex anatomy.
• Catheter stabilization proved crucial for procedural success.

Implications:

• This case highlights a practical solution for catheter stabilization during complex PCI.
• The findings may inform strategies for managing atherosclerotic disease in single coronary artery anomalies.
• Further research is needed to clarify the long-term prognosis and optimal management of single coronary artery anomalies.