Coronary anomalies are less frequent than acquired coronary diseases, such as atherosclerosis, and have been implicated as a cause of cardiovascular events. This case report describes an incidental finding on angiography of an anomalous right coronary artery with origin in the left coronary sinus and an intra-arterial course, after an episode of aborted sudden death. The Heart Team analysis indicated a percutaneous approach with drug-eluting stent implantation at the origin of the right coronary artery as the best treatment, and the procedure was successfully performed. This case report and recent studies have demonstrated percutaneous treatment of coronary anomalies is a safe option for selected patients, considering clinical presentation, anatomy study, and training of the cath lab team.

Pulmonary arteriovenous malformation is an abnormal communication between an artery and a vein, causing clinical manifestations, such as chronic hypoxemia and embolic events. Arteriovenous malformations were treated surgically, with a significant rate of complications. In the 1970 ́s, the first percutaneous catheter embolization was performed with coils. We describe three cases in which percutaneous embolization techniques were effective to prevent embolic, hemorrhagic, and hypoxemic events in the follow-up of patients.