Hell M, Schlundt C, Bittner DO, Achenbach S, Marwan M (2020)
Publication Type: Journal article
Publication year: 2020
DOI: 10.1016/j.jcct.2020.12.002
Background: An optimal aorto-coronary angiographic projection, characterized by an orthogonal visualization of the proximal coronary artery, is crucial for interventional success. We determined the distribution of optimal C-arm positions and assessed their feasibility by invasive coronary angiography. Methods: Orthogonal aorto-coronary ostial angulations were determined in 310 CT data sets. In 100 patients undergoing subsequent invasive angiography, we assessed if the CT-predicted angulations were achievable by the C-arm system. If the predicted projection was not achievable due to mechanical constraints of the C-arm system, the most close, achievable angulation was determined. Patient characteristics were analyzed regarding the distribution of optimal angulations and its feasibility by the C-arm system. Results: For the left ostium, CT revealed a mean angulation of LAO 23 ± 21°/cranial 25 ± 23° (90% of patients with a LAO/cranial angulation, 3% LAO/caudal, 4% RAO/cranial, 3% RAO/caudal) and were achievable by the C-arm system in 87% of patients. For the right ostium, the mean CT-predicted orthogonal angulation was LAO 36 ± 37°/cranial 36 ± 51° (84% LAO/cranial, 2% LAO/caudal, 14% RAO/caudal) and achievable by the C-arm system in 45% of patients. For the left ostium, a higher body weight was associated with a steeper LAO/cranial angulation being less feasible by the C-arm system due to mechanical constraints. Conclusions: Orthogonal aorto-left coronary angulations show a relative narrow distribution predominately in LAO/cranial position whereas a wider range of angulations was found for the right coronary ostium. The feasibility of CT-predicted angulations by the C-arm system is more restricted for the right than the left coronary ostium.
APA:
Hell, M., Schlundt, C., Bittner, D.O., Achenbach, S., & Marwan, M. (2020). Determination of optimal fluoroscopic angulations for aorto-coronary ostial interventions from coronary computed tomography angiography. Journal of Cardiovascular Computed Tomography. https://doi.org/10.1016/j.jcct.2020.12.002
MLA:
Hell, Michaela, et al. "Determination of optimal fluoroscopic angulations for aorto-coronary ostial interventions from coronary computed tomography angiography." Journal of Cardiovascular Computed Tomography (2020).
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