What are the left anterior descending artery anatomic findings on coronary computed tomography angiography (CCTA)?

Updated: Dec 21, 2017
  • Author: Eugene C Lin, MD; Chief Editor: Eugene C Lin, MD  more...
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Answer

Answer

The LAD is variable in length and can terminate before the apex, supply the apex, or supply the distal inferior wall.

The LAD gives rise to diagonal branches supplying the anterolateral wall and to septal perforators supplying the interventricular septum. Compared with the diagonals, the septal perforators usually are less implicated in ischemia and are less often targets of intervention.

In 1% of cases, there can be dual LADs. [71] In these cases, a short LAD terminates high in the interventricular groove. A long LAD originates as an early branch from the LAD proper or, less likely, from the RCA. The proximal LAD courses outside the interventricular groove, with the distal portion returning to the groove. This should be distinguished from a diagonal branch; the diagonal will not enter the interventricular groove distally.


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