Navigating the Uncommon: PCI to an Anomalous Right Coronary Artery With a Malignant Course Following Failed Arterial Grafts

A 67-year-old male presented with non-ST elevation myocardial infarction (NSTEMI) with underlying anomalous origin of the right coronary artery (RCA) and a malignant course between the aorta and pulmonary artery. Previous CABG with LIMA and RIMA grafts had failed, leaving the patient with severe in-...

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Main Authors: Ayman Helal, Mohsin Farooq, Mohamed Alama, Ibrahim Antoun
Format: Article
Language:English
Published: Wiley 2025-01-01
Series:Case Reports in Cardiology
Online Access:http://dx.doi.org/10.1155/cric/8125980
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author Ayman Helal
Mohsin Farooq
Mohamed Alama
Ibrahim Antoun
author_facet Ayman Helal
Mohsin Farooq
Mohamed Alama
Ibrahim Antoun
author_sort Ayman Helal
collection DOAJ
description A 67-year-old male presented with non-ST elevation myocardial infarction (NSTEMI) with underlying anomalous origin of the right coronary artery (RCA) and a malignant course between the aorta and pulmonary artery. Previous CABG with LIMA and RIMA grafts had failed, leaving the patient with severe in-stent restenosis (ISR) in the LAD and degenerated, blocked grafts. The patient underwent percutaneous coronary intervention (PCI) to the anomalous RCA, which posed challenges in engagement due to its anomalous course. This case report discusses the complexities of managing such anatomies, emphasizing the role of CT coronary angiography, the difficulty of engaging anomalous arteries, and the techniques used to achieve successful PCI.
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spelling doaj-art-5bcaff520bd44e64a515d3e1c7b241022025-08-20T03:07:25ZengWileyCase Reports in Cardiology2090-64122025-01-01202510.1155/cric/8125980Navigating the Uncommon: PCI to an Anomalous Right Coronary Artery With a Malignant Course Following Failed Arterial GraftsAyman Helal0Mohsin Farooq1Mohamed Alama2Ibrahim Antoun3Department of CardiologyDepartment of CardiologyCardiology imagingDepartment of CardiologyA 67-year-old male presented with non-ST elevation myocardial infarction (NSTEMI) with underlying anomalous origin of the right coronary artery (RCA) and a malignant course between the aorta and pulmonary artery. Previous CABG with LIMA and RIMA grafts had failed, leaving the patient with severe in-stent restenosis (ISR) in the LAD and degenerated, blocked grafts. The patient underwent percutaneous coronary intervention (PCI) to the anomalous RCA, which posed challenges in engagement due to its anomalous course. This case report discusses the complexities of managing such anatomies, emphasizing the role of CT coronary angiography, the difficulty of engaging anomalous arteries, and the techniques used to achieve successful PCI.http://dx.doi.org/10.1155/cric/8125980
spellingShingle Ayman Helal
Mohsin Farooq
Mohamed Alama
Ibrahim Antoun
Navigating the Uncommon: PCI to an Anomalous Right Coronary Artery With a Malignant Course Following Failed Arterial Grafts
Case Reports in Cardiology
title Navigating the Uncommon: PCI to an Anomalous Right Coronary Artery With a Malignant Course Following Failed Arterial Grafts
title_full Navigating the Uncommon: PCI to an Anomalous Right Coronary Artery With a Malignant Course Following Failed Arterial Grafts
title_fullStr Navigating the Uncommon: PCI to an Anomalous Right Coronary Artery With a Malignant Course Following Failed Arterial Grafts
title_full_unstemmed Navigating the Uncommon: PCI to an Anomalous Right Coronary Artery With a Malignant Course Following Failed Arterial Grafts
title_short Navigating the Uncommon: PCI to an Anomalous Right Coronary Artery With a Malignant Course Following Failed Arterial Grafts
title_sort navigating the uncommon pci to an anomalous right coronary artery with a malignant course following failed arterial grafts
url http://dx.doi.org/10.1155/cric/8125980
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