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| 1. PRXRCA (proximal right coronary artery). Main stem of RCA from the
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| ostium to one half the distance to the acute margin of the heart.
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| 2. MIDRCA (middle RCA). Main stem of RCA from end of above segment
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| to acute margin of the heart.
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| 3. DSTRCA (distal RCA). Main stem of RCA usually running along the
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| posterior right atrioventricular groove, from the acute margin of the heart to
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| the origin of the posterior descending artery (PDA).
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| 4. RPDA (right PDA). Artery of the posterior interventricular groove,
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| which gives off septal perforators and is supplied by the distal right (90%).
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| 5. RPLS (right posterolateral segment). Continuation of the distal right
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| beyond the origin of the posterior descending artery. This segment is situated
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| in the posterior atrioventricular groove, in the region of the crux of the heart,
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| and may have an inverted U-shaped configuration. It usually gives off the
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| A-V node artery and a variable number of branches, which run parallel to the
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| PDA, on the posterolateral surface (or inferior surface) of the left ventricle.
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| 6. RPL1 (first RPLS branch). First branch off the RPLS and often the only
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| branch; synonym, left ventricular branch.
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| 7. RPL2 (second RPLS branch). Usually not present.
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| 8. RPL3 (third RPLS branch). Usually not present.
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| 9. Inf Septal (inferior septal). Posterior descending septal arteries are the
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| septal perforator arteries originating from the PDA then extending into the
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| inferior septunm.
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| 10. AC MARG (acute marginal vessels). A large branch or branches supplying
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| the acute marginal wall of the right ventricle. The origin of the largest
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| of these vessels may be variable, but usually coincides with the acute margin
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| of the heart. These vessels are often an important source of collateral circulation.
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| 11. LMCA (left main coronary artery). Aortic ostium to bifurcation.
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| 12. PRXLAD (proximal left anterior descending). Extends from its origin
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| off the left coronary artery to the first visible septal no matter how small this
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| vessel is. In some cases there will be a major septal proceeded by one or more
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| small septals. In this instance, the definition should still be rigidly adhered to
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| and the first visible septal, no matter what size, should be used to indicate the
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| end of the proximal segment of the LAD.
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| 13. MIDLAD (middle LAD). LAD immediately distal to the origin of the
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| first major septal branch and extending to a point where the LAD forms an
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| angle (Right anterior oblique [RAO] view), often, but not always, coinciding
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| or close to the origin of the second diagonal branch. If said angle or branch
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| is not identifiable, the segment ends one half the distance from the first major
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| septal to the apex of the heart.
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| 14. DSTLAD (distal LAD). Terminal segment of the LAD running along
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| the interventricular sulcus, beginning with the end of the previous segment,
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| and usually extending beyond the apex.
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| 15. Ist DIAG (first diagonal; D-1). The largest, and usually the first, diagonal
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| branch having its origin from the proximal segment of the LAD and
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| supplying the anterior wall. Occasionally, a separate branch of the main left
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| coronary artery. If there is no diagonal with its origin from the proximal LAD,
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| then D-1 should be coded with a -5" under morphology of distal vessel to
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| signify anatomically not present.
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| 16. 2nd DIAG (second diagonal; D-2). The second diagonal branch, which
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| often has its origin at the angle of the anterior descending when visualized in
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| the RAO projection. Origin is usually near junction of middle and distal thirds
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| of LAD, but may come off higher, from MIDLAD.
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| 17. Ist Ant Septal (first anterior septal). This vessel is designated as the
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| first large branch of the LAD to penetrate into the anterior interventricular
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| septum.
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| 18. PRXCX (proximal circumflex). That portion of the circumflex artery
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| from its origin off the main left coronary artery to and including the origin
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| of the first obtuse marginal branch (No. 20). The distal circumflex (No. 19)
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| may originate before the first marginal but the proximal circumflex continues
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| until the origin of the first marginal.
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| 19. DSTCX (distal circumflex). Begins from the proximal portion of the
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| circumflex as the circumflex runs along or close to the posterior left atrioventricular
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| groove. In right dominant circulation, the distal circumflex may be
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| very small or absent.
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| Marginal circumflex branches that are very small or "twigs" are not to be
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| counted as marginals or described. The first marginal branch (No. 20) may
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| sometimes be a very large branch with the second marginal (No. 21) appearing
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| as a division of the first marginal. All branches that come off the distal circumflex
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| will be labeled marginals (Nos. 20, 21, and 22 below), and all branches
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| that come off the left atrioventricular artery will be labeled left posterolateral
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| branches (No. 24, 25, and 26 below).
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| 20. Ist OB MARC (first obtuse marginal). The first major branch of the
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| circumflex artery supplying the lateral left ventricular wall, in the general
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| area of the obtuse margin of the heart.
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| 21. 2nd OB MARC (second obtuse marginal). The second branch of the
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| circumflex distributing to the lateral surface of the ventricle. Sometimes
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| smaller in caliber than the first obtuse marginal. May be absent or may be a
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| division of the first obtuse marginal branch.
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| 22. 3rd OB MARC (third obtuse marginal). The third branch of the circumflex
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| supplying the posterolateral left ventricular wall (often absent). Runs
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| parallel to the LPDA in the left predominant pattern.
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| 23. LAV (left atrial ventricular artery). The left atrial ventricular artery
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| is present only in a left dominant or balanced circulation. This artery is a
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| continuation of the distal circumflex and has been arbitrarily defined as the
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| distal half of the remainder of the circumflex after the take-off of the first
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| marginal. The proximal half of the circumflex after the take-off of the first
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| marginal will be defined as the distal circumflex (No. 19). Note that this definition
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| is appropriate only for left dominant or balanced circulation.
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| Left posterolateral branches that are very small or "twigs" are not to be
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| counted as branches or described. The first left posterolateral branch (No. 24)
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| may sometimes be a very large branch with the second left posterolateral
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| branch (No. 25) appearing as a division of the first branch. All branches that
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| come off the distal circumflex will be labeled marginals (No. 20, 21, and 22),
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| and all branches that come off the left atrioventricular artery will be labeled
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| left posterolateral branches (Nos. 24, 25, and 26).
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| 24. 1st LPL (first left posterolateral branch). First branch off the LPL
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| segment and often the only branch; synonym, left ventricular branch.
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| 25. 2nd LPL (second left posterolateral branch). Second branch off the
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| LPL segment.
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| 26. 3rd LPL (third left posterolateral branch). Third branch off the LPL
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| segment. Usually not present.
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| 27. LPDA (left PDA). Posterior descending when present as a branch of
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| the circumflex in the predominant left coronary artery.
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