Percutaneous Coronary Intervention in Anomalously arising Coronary Arteries

Anomalous origin of coronary arteries (ACA) is rare. The objective of this communication is to describe the difficulties in angiographic recognition and challenges in percutaneous management.

The material for this retrospective study was provided by contributing interventional cardiologists practicing in tertiary care centers.

From 2010 to 2019, 27 patients underwent percutaneous coronary intervention (PCI) for ACA. Four groups were encountered including anomalous origin from opposite sinus [left anomalous coronary artery from opposite sinus (L-ACAOS, n = 5), right anomalous coronary artery from opposite sinus (R-ACAOS n = 4)], origin of left circumflex from right sinus (n = 12), and origin of right coronary artery from posterior sinus (n = 6). The selection of a guiding catheter is the crucial step and a wide range of accessories was required to achieve an excellent outcome. Radial access may have an advantage in R-ACAOS, although the majority had a successful procedure from the femoral approach.

Percutaneous management of patients with anomalous coronary arteries is challenging but can be accomplished with an excellent immediate outcome.