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An anomalous origin of the left circumflex is the most common congenital abnormality encountered in coronary angiography and it may selectively predispose to focal accelerated atherosclerotic disease. We report the case of a 54-year-old man who presented with non-ST elevation myocardial infarction and a characteristic retroaortic (proximal) culprit lesion in his anomalous circumflex artery. Intravascular ultrasound images illustrate the dynamic nature of the lumen compression. A "two wires-two vessel" angioplasty technique provided extra support and is recommended to facilitate successful anomalous circumflex percutaneous coronary interventions.

Original publication




Journal article


Int J Cardiol

Publication Date





e41 - e43


Angioplasty, Balloon, Coronary, Coronary Angiography, Coronary Stenosis, Coronary Vessel Anomalies, Humans, Male, Middle Aged, Myocardial Infarction, Ultrasonography, Interventional