A coronary computed tomography angiography study on anatomical characteristics of the diagonal branch of anterior interventricular artery

Zhang, Danqing; Xu, Yi; Dong, Ya-Peng; Yu, Shu-Jing

doi:10.5603/fm.a2022.0100

Cited by 1 publication

(1 citation statement)

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“…Conversely, the RI may have a diminutive effect on the diameters of the proximal LAD and LCX when located close to these arteries. However, if RI is precisely positioned between these arteries, its effect on their proximal diameter is minimal [19]. Additionally, some data indicate that the existence of RI is associated with an increased risk of branch point atherosclerosis [10,11,12,20].…”

Section: Discussionmentioning

confidence: 99%

The Ramus Intermedius: A Bridge to Survival in the Setting of Triple-Vessel Total Occlusion

Khachatryan,

Chow,

Srivastava

et al. 2024

Cureus

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Coronary artery disease continues to remain the leading cause of mortality worldwide. Coronary blood supply is provided through the right and left main coronary arteries. The left main coronary artery (LMCA) in turn gives rise to the left anterior descending (LAD) and left circumflex (LCX) arteries. In some cases, LMCA may trifurcate into the ramus intermedius (RI) in addition to the LAD and LCX arteries. Atherosclerotic plaque formation and rupture with subsequent clot formation and occlusion of coronary arteries are the underlying mechanisms of myocardial infarction. Though the clinical implications of the presence of ramus intermedius (RI) are controversial some data suggest that the RI is associated with an increased risk of atherosclerotic plaque formation in the LMCA and the proximal LAD. Conversely, it has been proposed that the RI provides an additional collateral source of blood supply to the myocardium and may potentially contribute to improved survival. Case reports tout the benefits of RI, specifically in the setting of multivessel coronary artery occlusions. Whether it increases the risk of atherosclerotic plaque formation or whether it is protective has yet to be determined. We present a case of a 58-year-old male who presented with acute coronary syndrome and cardiogenic shock due to total ostial occlusion of LAD. The patient had also chronic total occlusions of the right coronary artery and LCX but a patent RI, which was the only source of blood supply to the myocardium and practically determined the patient's survival. Additionally, we performed a literature review to identify similar cases, to support RI's potentially protective role in enhancing survival.

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Section: Discussionmentioning

confidence: 99%

The Ramus Intermedius: A Bridge to Survival in the Setting of Triple-Vessel Total Occlusion

Khachatryan,

Chow,

Srivastava

et al. 2024

Cureus

View full text Add to dashboard Cite

show abstract

A coronary computed tomography angiography study on anatomical characteristics of the diagonal branch of anterior interventricular artery

Abstract: This article has been peer reviewed and published immediately upon acceptance.It is an open access article, which means that it can be downloaded, printed, and distributed freely, provided the work is properly cited. Articles in "Folia Morphologica" are listed in PubMed.

Cited by 1 publication

References 13 publications

The Ramus Intermedius: A Bridge to Survival in the Setting of Triple-Vessel Total Occlusion

The Ramus Intermedius: A Bridge to Survival in the Setting of Triple-Vessel Total Occlusion

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