Distal LAD filling from homocollaterals

Distal LAD filling from homocollaterals

Left coronary angiogram showing total occlusion of left anterior descending coronary artery (LAD) with retrograde filling of distal LAD from homocollaterals. LMCA: Left main coronary artery; LCX: Left circumflex coronary artery. Here the collaterals are seen originating from a major diagonal branch of the LAD. The diagonal is originating proximal to the total occlusion and is a sizable vessel supplying homocollaterals (from the same vascular territory) to distal LAD. A right coronary injection would have shown whether there are heterocollaterals (from another vascular territory).

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