Initial clinical experience of selective coronary angiography using one prolonged injection and a 180 degrees rotational trajectory.
OBJECTIVE
Evaluate the safety of prolonged coronary injections during a rotational acquisition covering 180 degrees.


BACKGROUND
Rotational angiography has been adapted to coronary angiography and shown to reduce radiation and contrast exposure. Three-dimensional (3D) reconstructions and other advanced applications require imaging over a 180 degrees -arc with a single but longer injection of larger contrast volumes.


METHODS
Thirty patients referred for angiography were enrolled. Blood pressure (BP), heart rate (HR), symptoms, and ectopy were recorded before-and-after injections.


RESULTS
Pre and post-injection HRs for the LCA/RCA were not statistically different (LCA-pre-injection 63+/-13 bpm vs. LCA-post-injection 62+/-11 bpm, P=0.54 and RCA-pre-injection 65+/-12 bpm vs. RCA-post-injection 65+/-10, P=0.88). Central aortic pressure values were not statistically different for the RCA injections (RCA-systolic-pre-injection 118+/-14 mm Hg vs. RCA-systolic-post-injection 112+/-25 mm Hg, P=0.15, and RCA diastolic-pre-injection 69+/-9 mm Hg vs. RCA-diastolic-post-injection 60+/-10 mm Hg, P=0.88) but were statistically significant for the LCA injections (LCA systolic-pre-injection 122+/-19 mm Hg vs. LCA-systolic-post-injection 116+/-17 mm Hg, P=0.0004, and LCA-diastolic-pre-injection 69+/-10 mm Hg vs. LCA-diastolic-post-injection 65+/-9 mm Hg, P=0.0007). There were no symptoms or electrical events documented during or immediately post-injection.


CONCLUSIONS
This study demonstrates the feasibility and safety of longer coronary injections. There were no significant HR changes, clinically insignificant pressure changes, and no adverse reactions. Additional studies will be needed to assure its safety in a larger and clinically more varied patient population.
Garcia
Joel A
JA
Division of Cardiology, University of Colorado Health Sciences Center, Denver, Colorado 80262, USA.
Chen
S-Y James
SY
Messenger
John C
JC
Casserly
Ivan P
IP
Hansgen
Adam
A
Wink
Onno
O
Movassaghi
Babak
B
Klein
Andrew J
AJ
Carroll
John D
JD
D001011:Aorta / Q000503:physiopathology; D001794:Blood Pressure; D003287:Contrast Media / Q000008:administration & dosage* / Q000009:adverse effects; D017023:Coronary Angiography / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D006339:Heart Rate; D006801:Humans; D021621:Imaging, Three-Dimensional; D007267:Injections / Q000009:adverse effects; D008297:Male; D011829:Radiation Dosage; D011857:Radiographic Image Interpretation, Computer-Assisted; D012399:Rotation; D013997:Time Factors; D014283:Triiodobenzoic Acids / Q000008:administration & dosage* / Q000009:adverse effects
D003287:Contrast Media; D014283:Triiodobenzoic Acids; C044834:iodixanol