In coronary angiography, inability to selectively visualize anomalous coronary arteries is one of the major problems, which a cardiologist encounters during angiography. The process we expect to finish in 15 min can take hours. The angiography times exceeding 1 h are not uncommon. On 2.6% of coronary angiograms, anomalous origin of coronary arteries is encountered. In 0.58% of the cases, the left anterior descending artery (LAD) arises from a separate ostium. The absence of the left main coronary artery (LMCA) can be discerned directly on coronary angiograms obtained using selective visualization of the left circumflex (Cx) or LAD because in most of the cases, the LAD and circumflex artery (Cx) arise from separate ostia. In such situations and where it seems impossible to achieve imaging of anomalous coronary artery, catheter reshaping can be accepted as a solution. This method can be used looking for the carotid and vertebral arteries at the angiography performed via the radial or femoral route also the right and left coronary ostia with anomalous origin, that easily and safely.
Part of the book: Angiography