What does this research mean for the field?

Coronary computed tomography angiography detects coronary artery anomalies with a prevalence of 1.82%, identifying high take-off right coronary artery as the most common anomaly and revealing gender-specific variations such as malignant courses occurring exclusively in females. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This study aims to evaluate the effectiveness of coronary CT angiography for diagnosing and managing coronary artery anomalies while considering demographic variations.

February 26, 2026Open Access

Diagnosis, risk assessment, and surgical planning of coronary artery anomalies by CT angiography

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Suspected coronary artery disease or other cardiac symptoms (n=2786). Intervention: Coronary computed tomography angiography (CCTA). Primary outcome: Prevalence and anatomical characterization of coronary artery anomalies detected by CCTA.

Key Result

Coronary computed tomography angiography detected coronary artery anomalies in 1.82% of patients, with a high take-off right coronary artery being the most common anomaly (41.5%) and malignant coronary courses occurring exclusively in females (19%).

Key Points

This study aims to evaluate the effectiveness of coronary CT angiography for diagnosing and managing coronary artery anomalies while considering demographic variations.
Retrospective analysis of 2,786 patients who underwent coronary CT angiography.
Identification of 53 cases of coronary artery anomalies categorized by origin, course, and structure.
Use of dual-source CT scanner for imaging.
Prevalence of coronary artery anomalies was found to be 1.82%.
The most common anomaly identified was a high take-off origin of the right coronary artery (41.5%).
Left main anomalies were more frequent in males, while malignant courses occurred only in females (19%).
Additional findings included coronary stenosis and diverticula.

Study Design

Type

Observational (n=2,786)

Multicenter

Structured PICO

Population

2,786 patients undergoing coronary computed tomography angiography (CCTA) for suspected coronary artery disease, chest pain, or other indications, from which 53 patients (mean age 48.34, 60.4% male) were identified with coronary artery anomalies.

Intervention

Coronary computed tomography angiography (CCTA) using a dual-source 128x2-section DSCT scanner

Outcome

Prevalence and anatomical characteristics (origin, course, and structure) of coronary artery anomalies

CCTA is an effective non-invasive imaging modality for identifying coronary artery anomalies, revealing a 1.82% prevalence and significant sex-based anatomical differences that can guide surgical planning.

Limitations

Single-center study design
Relatively small number of patients with coronary anomalies (n=53)
Retrospective observational design
Lack of long-term clinical follow-up
Absence of predefined power analysis

Abstract

Purpose: This study evaluates the role of coronary computed tomography (CT) angiography in diagnosis and management of coronary artery anomalies and explores demographic variations.Materials and Methods: A retrospective analysis of 2,786 patients undergoing Coronary CT angiography from November 2018 to October 2023 identified 53 cases (21 females, 32 males) of coronary artery anomalies. Anomalies were classified by origin, course, and structure. Imaging was performed using a dual-source CT scanner. Results: Coronary artery anomaly prevalence was 1.82%. The most common anomaly was a high take-off origin of the right coronary artery (41.5%). Left main anomalies were more frequent in males, while malignant courses occurred only in females (19%). Additional findings included coronary stenosis and diverticula. Coronary CT angiography provided critical 3D visualization for preoperative planning and revealed gender-specific differences, emphasizing the need for tailored approaches. Conclusion: Coronary CT angiography is an indispensable tool for diagnosing and characterizing coronary artery anomalies. Its non-invasive imaging allows for detailed preoperative evaluation, improving clinical and surgical outcomes. This study underscores the importance of addressing demographic variations and highlights the need for standardized protocols and further multicenter research.

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