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Peer-reviewedCC BY-NC 4.0Archivos Peruanos de Cardiología y Cirugía Cardiovascular

Anomalous coronary origin and severe calcification: a challenge for percutaneous coronary intervention. Case report

  • Fernando Quevedo-Candela1,2
  • Christian Nolte Rickards3
  • Tomas Cieza1,2
  1. 1Sector de Hemodinamia y Cardiología Intervencionista, Institut Universitaire de Cardiologie et de Pneumologie de Québec (IUCPQ), Québec, Canada. Sector de Hemodinamia y Cardiología Intervencionista Institut Universitaire de Cardiologie et de Pneumologie de Québec (IUCPQ) Québec Canada
  2. 2Université Laval, Québec, Canada. Université Laval Université Laval Québec Canada
  3. 3Clínica Delgado, Lima, Peru. Clínica Delgado Lima Peru
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Abstract

We present the case of a 68-year-old man with stable angina and complex multivessel coronary artery disease. Computed tomography revealed a critically calcified stenosis of the left anterior descending artery and an anomalous origin of the right coronary artery from the left coronary sinus, with an interarterial course and severe calcification. Following initial revascularisation of the left anterior descending artery using rotational atherectomy, the right coronary artery was treated in a staged procedure. Because the severe stenosis and challenging ostial anatomy precluded advancement of an intracoronary imaging catheter, angiography-guided intravascular lithotripsy was performed. This approach enabled effective plaque modification and the successful implantation of two drug-eluting stents, with an optimal angiographic result. This case highlights the safety and effectiveness of intravascular lithotripsy as an alternative treatment for anomalous coronary anatomy and severely calcified lesions when intracoronary imaging guidance is not feasible

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Cite

BibTeXRIS
BibTeX
@article{quevedocandela2026anomalous,
  title = {{Anomalous coronary origin and severe calcification: a challenge for percutaneous coronary intervention. Case report}},
  author = {Fernando Quevedo-Candela and Christian Nolte Rickards and Tomas Cieza},
  journal = {Archivos Peruanos de Cardiología y Cirugía Cardiovascular},
  year = {2026},
  month = sep,
  doi = {10.47487/apcyccv.v7i3.629},
  url = {https://doi.org/10.47487/apcyccv.v7i3.629},
  note = {CC BY-NC 4.0},
}
RIS
TY  - JOUR
TI  - Anomalous coronary origin and severe calcification: a challenge for percutaneous coronary intervention. Case report
AU  - Fernando Quevedo-Candela
AU  - Christian Nolte Rickards
AU  - Tomas Cieza
PY  - 2026
DA  - 2026/09/26
JO  - Archivos Peruanos de Cardiología y Cirugía Cardiovascular
DO  - 10.47487/apcyccv.v7i3.629
UR  - https://doi.org/10.47487/apcyccv.v7i3.629
AB  - We present the case of a 68-year-old man with stable angina and complex multivessel coronary artery disease. Computed tomography revealed a critically calcified stenosis of the left anterior descending artery and an anomalous origin of the right coronary artery from the left coronary sinus, with an interarterial course and severe calcification. Following initial revascularisation of the left anterior descending artery using rotational atherectomy, the right coronary artery was treated in a staged procedure. Because the severe stenosis and challenging ostial anatomy precluded advancement of an intracoronary imaging catheter, angiography-guided intravascular lithotripsy was performed. This approach enabled effective plaque modification and the successful implantation of two drug-eluting stents, with an optimal angiographic result. This case highlights the safety and effectiveness of intravascular lithotripsy as an alternative treatment for anomalous coronary anatomy and severely calcified lesions when intracoronary imaging guidance is not feasible
SN  - 2708-7212
ER  -