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Updated: Jun 10, 2025

Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans

Published on: August 28, 2018

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Kugel's Artery in Coronary Computed Tomography Angiography in a Patient with Left Main Subtotal Stenosis

Paweł Gać1,2, Agnieszka Głuszczyk1, Jakub Plizga1

  • 1Centre of Diagnostic Imaging, 4th Military Hospital, Weigla 5, 50-981 Wrocław, Poland.

Diagnostics (Basel, Switzerland)
|October 16, 2024
PubMed

Insights

The artery of Kugel, a rare coronary artery variant, provides vital collateral circulation. Coronary computed tomography angiography effectively visualizes this artery, aiding in assessing myocardial protection during coronary artery disease.

Area of Science:

  • Cardiovascular anatomy
  • Interventional cardiology
  • Medical imaging

Background:

  • The artery of Kugel is a rare anatomical variant involving anastomotic connections between the right coronary artery (RCA) and left circumflex artery (LCx) branches.
  • This arterial connection can potentially act as a collateral pathway, bypassing occluded segments and preserving myocardial tissue.
  • Traditionally diagnosed via invasive coronary angiography, its visualization in clinical practice is infrequent.

Purpose of the Study:

  • To present a case documenting the artery of Kugel using coronary computed tomography angiography (CCTA).
  • To highlight the utility of CCTA in visualizing collateral circulation in patients with significant coronary artery disease.

Main Methods:

  • Case report of a 67-year-old patient with subtotal left main artery stenosis.
  • Utilized coronary computed tomography angiography (CCTA) for detailed anatomical assessment.
  • Analysis of CCTA images to identify and characterize the artery of Kugel and associated collateral flow.

Main Results:

  • CCTA successfully visualized the artery of Kugel in the patient.
  • The findings demonstrated the artery of Kugel acting as a significant collateral pathway.
  • This collateral circulation was evident despite severe stenosis in the left main coronary artery.

Conclusions:

  • Coronary computed tomography angiography is a valuable non-invasive tool for detecting the artery of Kugel.
  • The artery of Kugel represents an important source of rescue collateral circulation in patients with critical coronary artery stenosis.
  • Accurate identification of such variants can inform clinical management strategies for coronary artery disease.

Keywords:
Kugel’s arterycoronary computed tomography angiographyleft circumflexleft main stenosisright coronary artery

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