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“Scattergun” Right Coronary Artery: Heavy Calcifications in Chronic Total Occlusion Percutaneous Coronary Intervention: A Case Study

Year: 2026

Type: article

Abstract: Coronary calcifications reduce procedural success rates, increase the risk of complications, and worsen the outcomes of percutaneous coronary intervention (PCI). We report the case of a 74-year-old woman with multiple comorbidities who was admitted for chronic total occlusion (CTO) PCI of the right coronary artery (RCA). Coronary angiography revealed double CTO with severe calcifications and high anatomical complexity. After unsuccessful true lumen-to-true lumen crossing, an antegrade dissection and re-entry (ADR) strategy was successfully employed. Post-procedure angiography revealed an unusual "scattergun" appearance of the proximal RCA, a parallel extra-plaque lumen with implanted stents and an occluded true lumen, separated by calcified plaque. Clinical and angiographic outcomes remained favorable at 6-month follow-up.

Source: Catheterization and Cardiovascular Interventions

DOI: 10.1002/ccd.70454

Authors: Rafał Wyderka, Jakub Drozd, Dawid Ilnicki, Michał Borger

Institutions: Wrocław University of Science and Technology, Szpital im Tadeusza Marciniaka, Wroclaw Medical University

Language: English

Topic: Coronary Interventions and Diagnostics

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: bronze

OpenAlex ID: W7118170185

FWCI:

Cites: 3

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