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SUMMARY:

Co dominant.
LM: Medium caliber. Moderate thrombus mid extending to ostium LAD.
LAD: Medium caliber, becoming small proximal. 38% ulcerated plaque proximal. Mild irregularities mid and distal.
Cx: Medium caliber. Xience V stent (11/03/2020) proximal and mid. 80%>12% eccentric in-stent restenosis proximal and mid. Moderate thrombus distal. Collaterals from distal SP to distal.
RCA: Medium caliber. Moderate tortuosity. 100% stenosis proximal.

RIMA: Medium caliber RIMA graft connects to mid RCA. Graft is patent.

ANATOMICAL FINDINGS:

The coronary circulation is co dominant.

LM: The Left Main artery, arising from the left cusp, is a medium caliber vessel. This vessel trifurcates into the Left Anterior Descending, Left Circumflex, and Ramus Intermedius. There is a moderate thrombus in the mid segment extending to the ostium of the LAD.

LAD: The Left Anterior Descending artery, which arises from the LM, is a medium caliber vessel, becoming small in the proximal segment. There is a 38% ulcerated plaque in the proximal segment. There are mild irregularities in the mid and distal segments.
The Septal Perforator, arising from the mid segment, is a small caliber vessel.
The Diagonal, arising from the mid segment, is a small caliber vessel.
The Diagonal, arising from the mid segment, is a very small caliber vessel.

Cx: The Circumflex artery, which arises from the LM, is a medium caliber vessel. There is a Xience V stent (11/03/2020) in the proximal and mid segments. There is an 80%>12% eccentric in-stent restenosis in the proximal and mid segments. There is a moderate thrombus in the distal segment. Collaterals from the distal segment of the SP connect to the distal segment.

RI: The Ramus Intermedius, which arises from the LM, is a very small caliber vessel.
The Left Posterolateral Artery, arising from the distal segment, is a medium caliber vessel.

RCA: The Right Coronary Artery, arising from the right cusp, is a medium caliber vessel. There is moderate tortuosity beginning in the ostium. There is a 100% stenosis in the proximal segment.
The SinoAtrial, arising from the proximal segment, is a small caliber vessel.
The Right Posterior Descending Artery, arising from the distal segment, is a medium caliber vessel.

Bypass Grafts:

RIMA: A medium caliber arterial RIMA graft connects to the mid segment of the RCA. This graft is patent.