ArticleJournal of clinical practice and research2026
Coronary Artery Origin Anomalies on Coronary CT Angiography: A Single-Center Tertiary-Care Cohort.
Article in Journal of clinical practice and research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: In this single-center, tertiary-care coronary CT angiography (CCTA) series, we aimed to report the prevalence of coronary origin anomalies and describe the characteristics of their proximal course. Materials and Methods: This retrospective study included 3,181 consecutive CCTA examinations performed between January 1, 2020, and June 30, 2025. All scans were acquired using a 64-slice multidetector CT system (SOMATOM Definition AS+, Siemens Healthineers) with retrospective ECG gating. Two radiologists reviewed the studies, and examinations with suspected coronary origin anomalies were re-evaluated by consensus. Anomalies were classified according to the Angelini framework, and the proximal course was categorized as interarterial, retroaortic, transseptal/intraseptal, or prepulmonic. Results: Coronary artery origin anomalies were identified in 41 of 3,181 patients (1.29%). The largest subgroup was opposite-sinus origin (n=24, 0.76%), which included the right coronary artery (RCA) originating from the left sinus (n=12, 0.38%), the left circumflex artery (LCX) originating from the right coronary sinus (n=8, 0.26%), and the left main coronary artery (LMCA) originating from the right coronary sinus (n=4, 0.13%). An absent LMCA configuration-defined by separate left-sinus ostia for the left anterior descending artery (LAD) and LCX-was identified in 5 patients (0.16%). Single coronary artery anatomy was observed in 3 cases (0.09%), all of which had a common origin from the right coronary sinus. In one case (0.03%), the RCA arose from the noncoronary sinus. High take-off coronary artery origins were observed in 8 patients (0.26%). Regarding the course patterns, interarterial courses were observed in 20 patients, retroaortic courses in 10, and prepulmonic courses in 2. The interarterial LAD and LCX cases also demonstrated a transseptal/intraseptal segment. Conclusion: CCTA reliably delineates coronary ostial origin and proximal trajectory, supporting a comprehensive anatomic assessment of suspected congenital coronary variants.
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