Internal mammary angiography: a review of technical issues and newer methods.
Up to 90% of coronary bypass operations in some centers now include at least one IMA graft. In parallel with the increased use of IMA grafts, our catheterization laboratory records for 1986-7-8 demonstrate a progressive increase in IMA angiography, both absolutely (11, 28, 48 cases/yr) and as a percent of restudy procedures performed after prior bypass (14, 25, 43%). Unfortunately, these records also show that cannulation of the right and left IMAs may involve substantial technical hurdles, resulting in a mean time of 19 +/- 19 min from catheter insertion to selective IMA angiography. Based on this experience, we review a standard technique for IMA angiography using preformed catheters, and describe alternative methods (including use of PTCA guidewires with or without super-selective catheters, and non-selective angiography utilizing a specially designed balloon occlusion catheter).
Kuntz
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Charles A. Dana Research Institute, Beth Israel Hospital, Boston, MA 02215.
Baim
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D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000601:surgery; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis / Q000379:methods; D008323:Mammary Arteries / Q000000981:diagnostic imaging*; D009204:Myocardial Revascularization / Q000379:methods; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011859:Radiography; D013895:Thoracic Arteries / Q000000981:diagnostic imaging*