Left anterior descending coronary artery proximal

Figure 3.21 (A) ECG with a quite negative T wave in V1-V2 to V5, with extension to I and VL corresponding to a critical lesion in the proximal part of left anterior descending coronary artery that practically normalises during a chest pain crisis (B). This corresponds to an atypical pattern of STE-ACS (see Figure 8.3B). The normalisation of this...

Figure 4.10 In an acute coronary syndrome with ST-segment elevation in V1-V2 to V4-V6 as the most striking pattern, the occluded artery is the left anterior descending coronary artery (LAD). The correlation of the ST-segment elevation in V1-V2 to V4-V5 with the ST morphology in II, III and VF allows us to know if it is an occlusion proximal or distal to D1 (see Figure 4.43). If it is proximal, the involved muscular mass in the anterior wall is large and the injury vector is directed not only forward but also upward, even though there can be a certain...

Fig. 17.2. The influence of the stent size and the window settings on stent Imiien visualization. A 58-year-old patient with status post implantation of three stents in the left anterior descending coronary artery. A volmiie-rendered image (left) nicely shows the location of the first stent distal to the first diagonal branch and the other two stents distal of the second diagonal branch. On the right, curved MPR through the left anterior descending coronary artery are shown, with six different window settings. The wider the window, the better visible is the stent Imiien. With a window width of 400 and a window center of 160 the stent Imiien is not visible at all window settings of 1,500/300 are recommended. Note also the influence of the stent diameter on the lumen visibility. While the lumen of the proximal stent with a diameter of approx. 3.5 mm is nicely assessable, the most distal stent with a diameter of 2 mm is not evaluable...

In Fig. 2.2, the PET perfusion images show severe stenosis or occlusion of the left circumflex (LCx) and right (RCA) coronary arteries with a moderately severe stenosis of the left anterior descending (LAD) coronary artery proximal to its second diagonal branch. The ejection fraction (EF) and regional LV contraction were normal. Therefore, this example illustrates purely ischemic myocardium without scar and without injured or poorly contracting myocardium. 

The most frequent locations of the target lesion were the mid-left anterior descending vessel (39 patients, 23%), proximal left descending vessel (37 patients, 21 %), and mid-right coronary artery (35 patients, 20%). Mean lesion length was I 1.5 5.0 mm (range from 4 to 25 mm). The most commonly recorded target lesion classification was type BI (86 patients, 50%). 

A 73-year-old man with a history of breathlessness, cough, and weight loss had some ill-defined peripheral shadow in the upper zones of a chest X-ray. He had fiberoptic bronchoscopy with cocaine and lidocaine and 5 minutes later became distressed, with dyspnea, chest pain, and tachycardia. Electrocardiography showed an evolving anterior myocardial infarction. Coronary angiography showed a stenosis of less than 25% in the proximal left anterior descending artery with coronary artery spasm. He made an uneventful recovery. 

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