When is Rotational Angiography Superior to Conventional Single-plane Angiography for Planning Coronary Angioplasty?

Overview

Journal Catheter Cardiovasc Interv

Specialty Cardiology & Vascular Diseases

Date 2015 May 28

PMID 26012725

Citations 2

Authors

Paul D Morris

Jane Taylor

Sara Boutong

Sarah Brett

Amal Louis

James Heppenstall

Allison C Morton

Julian P Gunn

Affiliations

Soon will be listed here.

Abstract

Objectives: To investigate the value of rotational coronary angiography (RoCA) in the context of percutaneous coronary intervention (PCI) planning.

Background: As a diagnostic tool, RoCA is associated with decreased patient irradiation and contrast use compared with conventional coronary angiography (CA) and provides superior appreciation of three-dimensional anatomy. However, its value in PCI remains unknown.

Methods: We studied stable coronary artery disease assessment and PCI planning by interventional cardiologists. Patients underwent either RoCA or conventional CA pre-PCI for planning. These were compared with the referral CA (all conventional) in terms of quantitative lesion assessment and operator confidence. An independent panel reanalyzed all parameters.

Results: Six operators performed 127 procedures (60 RoCA, 60 conventional CA, and 7 crossed-over) and assessed 212 lesions. RoCA was associated with a reduction in the number of lesions judged to involve a bifurcation (23 vs. 30 lesions, P < 0.05) and a reduction in the assessment of vessel caliber (2.8 vs. 3.0 mm, P < 0.05). RoCA improved confidence assessing lesion length (P = 0.01), percentage stenosis (P = 0.02), tortuosity (P < 0.04), and proximity to a bifurcation (P = 0.03), particularly in left coronary artery cases. X-ray dose, contrast agent volume, and procedure duration were not significantly different.

Conclusions: Compared with conventional CA, RoCA augments quantitative lesion assessment, enhances confidence in the assessment of coronary artery disease and the precise details of the proposed procedure, but does not affect X-ray dose, contrast agent volume, or procedure duration.

Citing Articles

Usefulness of dual-axis rotational coronary angiography in primary percutaneous coronary intervention for patients with ST-elevation myocardial infarction.

Suwa H, Koyabu Y, Adachi T, Kawai A, Kotani K, Toyoda S Heart Vessels. 2020; 36(5):621-629.

PMID: 33277662 PMC: 8032619. DOI: 10.1007/s00380-020-01738-2.

Correlation between dual-axis rotational coronary angiography and intravascular ultrasound in a coronary lesion assessment.

Jin Z, Zhang Z, Jing L, Wei Y, Zhang J, Luo J Int J Cardiovasc Imaging. 2016; 33(2):153-160.

PMID: 27730313 DOI: 10.1007/s10554-016-0999-5.

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