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Intermediate Technical IVT

LAD wrap-around

Also written as: LAD — Left Anterior Descending

An anatomical variant where the left anterior descending artery extends beyond the cardiac apex.

Full Definition

LAD wrap-around is a coronary anatomical variant where the left anterior descending artery extends beyond the cardiac apex to supply the inferior wall of the left ventricle, territory typically served by the posterior descending artery. This variant occurs when the right coronary artery is non-dominant or absent, forcing the LAD to compensate by extending around the apex. Recognition of this anatomy is crucial during angiographic interpretation and revascularization planning, as LAD occlusion in these patients can cause inferior wall ischemia in addition to anterior wall involvement.

Usage

Usage note: Hyphenate 'wrap-around' when used as compound modifier. LAD should be spelled out on first use.

In Context

  • "The patient demonstrated LAD wrap-around anatomy with absence of a posterior descending artery." — Angiographic report
  • "LAD wrap-around variants require careful assessment of inferior wall perfusion during anterior interventions." — Procedural planning

Also known as

wrap-around LAD LAD extension

Don't confuse with

LAD dominance ramus intermedius

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