Coronary artery disease can affect the septal perforator arteries and cause clinical sequelae, including angina, infarction of the interventricular septum, arrhythmias, and congestive heart failure. However, the size and the course of the septal perforator arteries significantly differ from those of the major epicardial coronary vessels. These anatomic features present certain technical challenges for angioplasty of the septal arteries. This case demonstrates that application of an ultralow-profile balloon-over-the-wire system can meet the specific requirements of septal artery angioplasty and achieve adequate results.
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