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Optimal Fluoroscopic Projections of Coronary Ostia and Bifurcations Defined by Computed Tomographic Coronary Angiography

V. Kočka, P. Thériault-Lauzier, TY. Xiong, J. Ben-Shoshan, R. Petr, M. Laboš, J. Buithieu, N. Mousavi, T. Pilgrim, F. Praz, P. Overtchouk, JP. Beaudry, M. Spaziano, JP. Pelletier, G. Martucci, S. Dandona, S. Rinfret, S. Windecker, J. Leipsic, N. Piazza

. 2020 ; 13 (21) : 2560-2570. [pub] 20200720

Jazyk angličtina Země Spojené státy americké

Typ dokumentu časopisecké články, práce podpořená grantem

Perzistentní odkaz   https://www.medvik.cz/link/bmc21026423

OBJECTIVES: The aim of this study was to define the optimal fluoroscopic viewing angles of both coronary ostia and important coronary bifurcations by using 3-dimensional multislice computed tomographic data. BACKGROUND: Optimal fluoroscopic projections are crucial for coronary imaging and interventions. Historically, coronary fluoroscopic viewing angles were derived empirically from experienced operators. METHODS: In this analysis, 100 consecutive patients who underwent computed tomographic coronary angiography (CTCA) for suspected coronary artery disease were studied. A CTCA-based method is described to define optimal viewing angles of both coronary ostia and important coronary bifurcations to guide percutaneous coronary interventions. RESULTS: The average optimal viewing angle for ostial left main stenting was left anterior oblique (LAO) 37°, cranial (CRA) 22° (95% confidence interval [CI]: LAO 33° to 40°, CRA 19° to 25°) and for ostial right coronary stenting was LAO 79°, CRA 41° (95% CI: LAO 74° to 84°, CRA 37° to 45°). Estimated mean optimal viewing angles for bifurcation stenting were as follows: left main: LAO 0°, caudal (CAU) 49° (95% CI: right anterior oblique [RAO] 8° to LAO 8°, CAU 43° to 54°); left anterior descending with first diagonal branch: LAO 11°, CRA 71° (95% CI: RAO 6° to LAO 27°, CRA 66° to 77°); left circumflex bifurcation with first marginal branch: LAO 24°, CAU 33° (95% CI: LAO 15° to 33°, CAU 25° to 41°); and posterior descending artery and posterolateral branch: LAO 44°, CRA 34° (95% CI: LAO 35° to 52°, CRA 27° to 41°). CONCLUSIONS: CTCA can suggest optimal fluoroscopic viewing angles of coronary artery ostia and bifurcations. As the frequency of use of diagnostic CTCA increases in the future, it has the potential to provide additional information for planning and guiding percutaneous coronary intervention procedures.

Citace poskytuje Crossref.org

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$a Optimal Fluoroscopic Projections of Coronary Ostia and Bifurcations Defined by Computed Tomographic Coronary Angiography / $c V. Kočka, P. Thériault-Lauzier, TY. Xiong, J. Ben-Shoshan, R. Petr, M. Laboš, J. Buithieu, N. Mousavi, T. Pilgrim, F. Praz, P. Overtchouk, JP. Beaudry, M. Spaziano, JP. Pelletier, G. Martucci, S. Dandona, S. Rinfret, S. Windecker, J. Leipsic, N. Piazza
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$a OBJECTIVES: The aim of this study was to define the optimal fluoroscopic viewing angles of both coronary ostia and important coronary bifurcations by using 3-dimensional multislice computed tomographic data. BACKGROUND: Optimal fluoroscopic projections are crucial for coronary imaging and interventions. Historically, coronary fluoroscopic viewing angles were derived empirically from experienced operators. METHODS: In this analysis, 100 consecutive patients who underwent computed tomographic coronary angiography (CTCA) for suspected coronary artery disease were studied. A CTCA-based method is described to define optimal viewing angles of both coronary ostia and important coronary bifurcations to guide percutaneous coronary interventions. RESULTS: The average optimal viewing angle for ostial left main stenting was left anterior oblique (LAO) 37°, cranial (CRA) 22° (95% confidence interval [CI]: LAO 33° to 40°, CRA 19° to 25°) and for ostial right coronary stenting was LAO 79°, CRA 41° (95% CI: LAO 74° to 84°, CRA 37° to 45°). Estimated mean optimal viewing angles for bifurcation stenting were as follows: left main: LAO 0°, caudal (CAU) 49° (95% CI: right anterior oblique [RAO] 8° to LAO 8°, CAU 43° to 54°); left anterior descending with first diagonal branch: LAO 11°, CRA 71° (95% CI: RAO 6° to LAO 27°, CRA 66° to 77°); left circumflex bifurcation with first marginal branch: LAO 24°, CAU 33° (95% CI: LAO 15° to 33°, CAU 25° to 41°); and posterior descending artery and posterolateral branch: LAO 44°, CRA 34° (95% CI: LAO 35° to 52°, CRA 27° to 41°). CONCLUSIONS: CTCA can suggest optimal fluoroscopic viewing angles of coronary artery ostia and bifurcations. As the frequency of use of diagnostic CTCA increases in the future, it has the potential to provide additional information for planning and guiding percutaneous coronary intervention procedures.
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$a Ben-Shoshan, Jeremy $u Department of Medicine, Division of Cardiology, McGill University Health Centre, Montreal, Quebec, Canada; Tel-Aviv Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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$a Petr, Róbert $u Third Faculty of Medicine, Charles University, Prague, Czech Republic; Cardiocenter, University Hospital Královské Vinohrady, Prague, Czech Republic
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$a Laboš, Marek $u Cardiocenter, University Hospital Královské Vinohrady, Prague, Czech Republic
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$a Pelletier, Jean-Philippe $u Department of Medicine, Division of Cardiology, McGill University Health Centre, Montreal, Quebec, Canada
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$a Martucci, Giuseppe $u Department of Medicine, Division of Cardiology, McGill University Health Centre, Montreal, Quebec, Canada
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$a Dandona, Sonny $u Department of Medicine, Division of Cardiology, McGill University Health Centre, Montreal, Quebec, Canada
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$a Rinfret, Stéphane $u Department of Medicine, Division of Cardiology, McGill University Health Centre, Montreal, Quebec, Canada
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$a Windecker, Stephan $u Department of Cardiology, Swiss Cardiovascular Center, Bern, Switzerland
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$a Leipsic, Jonathon $u Department of Radiology, St. Paul Hospital, Vancouver, British Columbia, Canada
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