Origen coronario atípico y calcificación severa: un reto en la intervención coronaria percutánea. Reporte de caso

Fernando Quevedo-Candela; Christian Nolte Rickards; Tomas Cieza

doi:10.47487/apcyccv.v7i3.629

Authors

Fernando Quevedo-Candela Sector de Hemodinamia y Cardiología Intervencionista, Institut Universitaire de Cardiologie et de Pneumologie de Québec (IUCPQ), Québec, Canadá; Université Laval, Québec, Canadá. https://orcid.org/0009-0009-5700-4372
Christian Nolte Rickards Clínica Delgado, Lima, Perú. https://orcid.org/0000-0001-6910-6880
Tomas Cieza Sector de Hemodinamia y Cardiología Intervencionista, Institut Universitaire de Cardiologie et de Pneumologie de Québec (IUCPQ), Québec, Canadá; Université Laval, Québec, Canadá. https://orcid.org/0000-0002-8547-3004

DOI:

https://doi.org/10.47487/apcyccv.v7i3.629

Keywords:

Coronary Vessel Anomalies, Lithotripsy, Percutaneous Coronary Intervention, Computed Tomography Angiography, Vascular Calcification

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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