Left anterior descending artery

The left anterior descending (LAD) artery, also known as the anterior interventricular branch, is a branch of the left coronary artery

It can be divided into proximal, mid and distal segments and this helps to differentiate the names of its various small branches 1:

  • origin: left coronary artery
  • branches 4
    • septal perforators: course to the right towards the septum on axial CTCA
    • diagonal branches: course to the left on the anterolateral wall of the left ventricle on axial CTCA
  • segments
    • proximal: from the origin the the first diagonal branch (D1) (although some authors use the first septal perforator (S1) as the landmark)
    • mid: from the origin of D1 to half the distance from the the D1 origin to the apex
    • distal: distal to half the distance from the the D1 origin to the apex

The LAD lies in the epicardial fat within the anterior interventricular septum 1

It supplies the anterolateral myocardium and apex with one of its branches supplying the anterior two-thirds of the interventricular septum. 

  • dual left anterior descending coronary artery 2:  two left anterior descending coronary arteries (one usually shorter in length) that are both situated in the anterior interventricular groove
    • it is important to know of this variation when planning surgical vascularisation 3
  • the mid 1/3rd of the LAD is known on occasion to course through the myocardium, known as myocardial bridging; does not have any clinical significance.
  • occlusion of LAD leading to myocardial infarction or sudden cardiac death
  • Wellens syndrome
Thoracic anatomy
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Article information

rID: 35317
Systems: Vascular, Cardiac
Section: Anatomy
Synonyms or Alternate Spellings:
  • LAD
  • LAD artery
  • Left anterior descending artery (LAD)

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