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Rotational vs. standard coronary angiography: An image content analysis

2008; Wiley; Volume: 73; Issue: 6 Linguagem: Inglês

10.1002/ccd.21918

1522-726X

Joel A. Garcia, Pierfrancesco Agostoni, Nathan E. Green, James T. Maddux, S.‐Y. James Chen, John C. Messenger, Ivan P. Casserly, Adam Hansgen, Onno Wink, Babak Movassaghi, Bertron Μ. Groves, Paul van den Heuvel, Stefan Verheye, Glenn Van Langenhove, Paul Vermeersch, F. Van Den Branden, Yerem Yeghiazarians, Andrew D. Michaels, John D. Carroll,

Advanced MRI Techniques and Applications

Abstract Objective : To evaluate the clinical utility of images acquired from rotational coronary angiographic (RA) acquisitions compared to standard “fixed” coronary angiography (SA). Background : RA is a novel angiographic modality that has been enabled by new gantry systems that allow calibrated automatic angiographic rotations and has been shown to reduce radiation and contrast exposure compared to SA. RA provides a dynamic multiple‐angle perspective of the coronaries during a single contrast injection. Methods : The screening adequacy, lesion assessment, and a quantitative coronary analysis (QCA) of both SA and RA were compared by independent blinded review in 100 patients with coronary artery disease (CAD). Results : SA and RA recognize a similar total number of lesions ( P = 0.61). The qualitative assessment of lesion characteristics and severity between modalities was comparable and lead to similar clinical decisions. Visualization of several vessel segments (diagonal, distal RCA, postero‐lateral branches and posterior‐descending) was superior with RA when compared to SA ( P < 0.05). A QCA comparison (MLD, MLA, LL, % DS) revealed no difference between SA and RA. The volume of contrast (23.5 ± 3.1 mL vs. 39.4 ± 4.1; P = 0.0001), total radiation exposure (27.1 ± 4 vs. 32.1 ± 3.8 Gycm 2 ; P = 0.002) and image acquisition time (54.3 ± 36.8 vs. 77.67 ± 49.64 sec; P = 0.003) all favored RA. Conclusion : Coronary lesion assessment, coronary screening adequacy, and QCA evaluations are comparable in SA and RA acquisition modalities in the diagnosis of CAD however RA decreases contrast volume, image acquisition time, and radiation exposure. © 2009 Wiley‐Liss, Inc.