Left anterior descending artery

Changed by Henry Knipe, 1 May 2015

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

Gross anatomy

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
branches⁴:
- septal perforators ~~(which~~: course to the right towards the septum on axial ~~CTA) and~~ CTCA
- diagonal branches ~~(which~~: course to the left on the anterolateral wall of the left ventricle on axial CTCA)
segments:
- proximal ~~- from~~: from the origin the the first diagonal branch (D1) (although some authors ~~and cardiologists~~ use the first septal perforator (S1) as the landmark)
- mid ~~- from~~: from the origin of D1 to half the distance from the the D1 origin to the apex
- distal ~~- distal~~: distal to half the distance from the the D1 origin to the apex

Relations

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

inferior: myocardium
superior: pericardium

Supply

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

Variant anatomy

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

Related pathology

occlusion of LAD leading to myocardial infarction or sudden cardiac death
Wellens syndrome

-<li>branches4: septal perforators (which course to the right towards the septum on axial CTA) and <a href="/articles/diagonal-branches-of-the-left-anterior-descending-artery">diagonal branches</a> (which course to the left on the anterolateral wall of the left ventricle on axial CTCA)</li>
~~-<li>segments:<ul>~~
-<li>proximal - from the origin the the first <a href="/articles/diagonal-branches-of-the-left-anterior-descending-artery">diagonal branch </a>(D1) (although some authors and cardiologists use the first septal perforator (S1) as the landmark)</li>
~~-<li>mid - from the origin of D1 to half the distance from the the D1 origin to the apex</li>~~
~~-<li>distal - distal to half the distance from the the D1 origin to the apex</li>~~
+<li>branches 4<ul>
+<li>
+septal perforators: course to the right towards the septum on axial CTCA</li>
+<li>
+<a href="/articles/diagonal-branches-of-the-left-anterior-descending-artery">diagonal branches</a>: course to the left on the anterolateral wall of the <a title="Left ventricle" href="/articles/left-ventricle">left ventricle</a> on axial CTCA</li>
+</ul>
+</li>
+<li>segments<ul>
+<li>proximal: from the origin the the first <a href="/articles/diagonal-branches-of-the-left-anterior-descending-artery">diagonal branch</a> (D1) (although some authors use the first septal perforator (S1) as the landmark)</li>
+<li>mid: from the origin of D1 to half the distance from the the D1 origin to the apex</li>
+<li>distal: distal to half the distance from the the D1 origin to the apex</li>

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