MDCT coronary angiography was done on 128-slice CT scanner, which showed absent left circumflex artery
with normal right coronary artery and left anterior descending artery (Fig.
Prognostic outcomes of patients with acute myocardial infarction due to left anterior descending artery LAD and right coronary artery RCA has been well studied but prognostic outcome of left circumflex artery
LCx related acute inferior wall MI is not much clear.
Caption: Figure 1: Left coronary angiography demonstrating severe stenosis of the left circumflex artery
and CTO of the LAD.
Following RCA circumflex artery
showed the next incidence seen in 31 cases with a mean value of 6.83 [+ or -] 15.535 (see Figure 11).
Thirty two stents were inserted in left anterior descending branch, 10 in left circumflex artery
and 20 in right coronary artery.
Left coronary angiogram demonstrates an anomalous right bronchial artery originating from the circumflex artery
However, some CTO lesions involve the ipsilateral collateral artery, such as the left anterior descending artery (LAD) to the left circumflex artery
(LCX) or bridge collateral arteries.
One of them, the right coronary artery started from the left posterior sinus, with the circumflex artery
starting from the right posterior sinus; in one case, the circumflex artery
started from the right coronary artery; and one case was single ostium, starting from the left posterior sinus of the pulmonary artery.
Left anterior descending (LAD) was the culprit artery in 1115 (56.1%) patients followed by right coronary artery (RCA) 659 (33.2%) and left circumflex artery
(LCX) in 174 (8.8%) cases (p<0.001).
Of the total 7 cases with coronary artery anomalies of origin and course, 2 patients had origin of the circumflex artery
from the right coronary sinus, 2 patients had separate origin of the left anterior descending artery and circumflex artery
from the left coronary sinus, one patient had left coronary artery originating from right sinus of valsalva and one patient had left coronary artery originating from pulmonary artery (ALCAPA) and one patient had congenitally absent left circumflex artery
4 cases were anterior descending artery lesion, two were right coronary artery lesion, two were circumflex artery
lesion; six cases were both anterior descending artery lesion and circumflex artery
, eight were anterior descending artery and right coronary artery lesion, 4 were circumflex and right coronary artery lesion.
Blood flow changes of the anterior humeral circumflex artery
decrease with the scapula in internal rotation.
His coronary angiogram showed total occlusion of the proximal segment of left anterior descending artery (LAD) and saphenous grafts to the circumflex artery
and the right coronary artery were patent (Fig.
Urgent coronary angiography was preformed which identified no crucial stenosis in the left anterior descending artery, left circumflex artery
, and posterior descending artery.
Angiography revealed occlusion at the left distal circumflex artery
and culprit vessel [Figure 1]a.