Posterior right diagonal artery. An angiographic study

Area of Science:

• Cardiovascular Imaging
• Interventional Cardiology
• Anatomical Studies

Background:

• The right coronary artery (RCA) has several epicardial branches crucial for myocardial perfusion.
• Accurate identification of these branches is essential for diagnosing coronary artery disease.
• The posterior right diagonal artery (PRDA) is often difficult to distinguish from other RCA branches.

Purpose of the Study:

• To prospectively visualize the posterior right diagonal artery (PRDA) using coronary angiography.
• To differentiate the PRDA from other epicardial branches of the right coronary artery (RCA), specifically the right marginal artery and posterior descending artery (PDA).
• To determine the incidence and anatomical variations of the PRDA.

Main Methods:

• Prospective analysis of coronary angiographic findings in 607 patients.
• Detailed examination of the distal third of the RCA for the presence and origin of the PRDA.
• Classification of coronary circulation dominance (right, left, balanced) and PDA length (short, long).

Main Results:

• The PRDA was present in 81 (15.1%) of 535 patients with right dominant coronary circulation.
• PRDA incidence was 15.4% in balanced circulation and 0% in left dominant circulation.
• PRDA was found in 40% of patients with a short PDA versus 8% with a long PDA.

Conclusions:

• The PRDA is an important coronary artery branch that should be actively sought during coronary angiography.
• Its presence and origin vary, particularly in relation to PDA length and coronary dominance.
• Understanding PRDA anatomy is vital for accurate interpretation of coronary arteriograms and potential perfusion territories.