What is distal LAD disease?

Distal LAD disease

Summary: LAD is short for left anterior descending coronary artery, branch of left main coronary artery, which supplies blood to the front portion of left ventricle. Distal LAD disease is presence of plaques in the vessel beyond two major branches.

Coronary angiogram showing left anterior descending (LAD) coronary with distal LAD disease (marked as LAD stenosis). LMCA: Left main coronary artery, LCX: Left circumflex coronary artery. Diagonal branch marked in the image is 4th diagonal branch which is the largest one here. First three diagonal branches (not marked) are smaller.

LAD is short for left anterior descending coronary artery, an important branch of left main coronary artery, which supplies oxygenated blood to a major portion of the left ventricle. The vessel regions are divided into proximal, mid and distal. Proximal means the initial region near the origin. Distal means the region near the end. Mid naturally indicates the region in between. Distal disease means that narrowing of the vessel is near its terminal region. Hence distal LAD disease is likely to be less dangerous than a proximal LAD disease. Technically, proximal LAD is the region from the origin to the first branch, which could be either a septal (supplying blood to the interventricular septum, separating the right and left ventricles) or a diagonal (supplying blood to the left side wall of the left ventricle). Region between the first branch and the second diagonal branch is called mid LAD. Region beyond the second diagonal branch is known as distal LAD. Distal LAD disease is usually treated medically while proximal and mid LAD disease, if critical, can be treated by angioplasty (balloon inflation within the vessel using special catheters) or bypass grafting (CABG or coronary artery bypass grafting operation).