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Anomalies of the coronary arteries are reported in 1-2% of patients among diagnostic angiogram. Ectopic origin of right coronary artery from opposite sinus one of the most common and they are mainly benign, at times may be malignant. We report a case of a 72-old male who underwent percutaneous coronary intervention for chronic stable angina who had critically diseased obtuse marginal branch, and anomalous right coronary artery (RCA) arising from left aortic sinus on coronary angiogram, and various technical challenges during the procedure. RCA was cannulated using Judkins left guiding catheter and revascularised by deployment of 2.75x18 mm Promus Premier Stent (everolimus eluting stent, Boston Scientific, USA) at 12 atm.

Anomalous Right Coronary Artery from the left aortic sinus: technical issues during revascularization