Anomalous Coronary Artery From the Opposite Sinus (ACAOS): Technical Challenges During Percutaneous Coronary Intervention

Santosh Kumar Sinha, Mahmodula Razi, Anupam Mahrotra, Puneet Aggarwal, Anupam Singh, Lokendra Rekwal, Sunil Tripathi, Nishant Kumar Abhishekh, Vinay Krishna

Abstract


Anomalies of the coronary arteries are reported in 1-2% of patients among diagnostic angiogram. Ectopic origin of right coronary artery (RCA) from opposite sinus is one of the most common and they are mainly benign, but at times may be malignant. We report a case of a 69-year-old male who underwent early invasive percutaneous coronary intervention for non-ST-segment elevation myocardial infarction (NSTEMI) where RCA arising from left sinus at the root of left main artery was culprit and various technical challenges were encountered while intervening in form of cannulation to tracking of hardwares. RCA was cannulated with floating wire technique using hockey stick guide catheter and revascularized by deployment of 3.5 × 38 mm Promus Premier Everolimus eluting stent (Boston Scientific, USA). To the best of our knowledge, this is the first ever report of ectopic RCA being revascularized by using hockey stick catheter.




Cardiol Res. 2018;9(2):120-124
doi: https://doi.org/10.14740/cr630w


Keywords


Anomalous right coronary artery; Floating wire technique; Hockey stick guide; Early invasive intervention; Non-ST segment elevation myocardial infarction

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