A 77-year-old man, who was dyslipidemic and hypertensive, and had recently experienced an inferior myocardial infarction with an impaired ejection fraction, was referred to our catheterization laboratory for diagnostic coronary angiography. Coronary angiography (Fig 1
, left, a) revealed single-vessel coronary disease with a tight, calcific stenosis at the end of the proximal right coronary followed by a large aneurysm involving the whole mid-portion of the vessel (quantitative coronary measurement: length, 33 mm; transversal maximum diameter, 28 mm). In the third segment of the vessel, a moderate calcific stenosis (ie, 50 to 60%) was also present. An elective percutaneous coronary intervention with the aim of dilating the two coronary stenoses and excluding the coronary aneurysm was planned.