Woven coronary artery: A case report

BACKGROUND: Woven coronary artery is an extremely rare disease with unknown etiology. This condition is difficult to diagnosis by traditional methods. CASE SUMMARY: A 67-year-old male presented to the cardiology department with a history of mild chest pain for 6 mo. Coronary computed-tomography angiography revealed a soft plaque with a 40% stenosis in the right coronary artery (RCA). A linear shadow was seen both on left circumflex (LCX) and RCA. Further coronary angiography showed an 80% regional stenosis in the area proximal of LCX and RCA, and it was divided into different channels with diffuse stenosis. Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) were performed in RCA. These confirmed a woven coronary artery. No stent was implanted. He remained asymptomatic during the 5-year follow-up period. CONCLUSION: Woven coronary artery can be distinguished from spontaneous dissection and revascularization of thrombosis. IVUS and OCT are useful in obtaining a definite diagnosis, which decreases chances of unnecessary intervention.