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).