Rotational vs. standard coronary angiography: an image content analysis.
OBJECTIVE
To evaluate the clinical utility of images acquired from rotational coronary angiographic (RA) acquisitions compared to standard "fixed" coronary angiography (SA).


BACKGROUND
RA is a novel angiographic modality that has been enabled by new gantry systems that allow calibrated automatic angiographic rotations and has been shown to reduce radiation and contrast exposure compared to SA. RA provides a dynamic multiple-angle perspective of the coronaries during a single contrast injection.


METHODS
The screening adequacy, lesion assessment, and a quantitative coronary analysis (QCA) of both SA and RA were compared by independent blinded review in 100 patients with coronary artery disease (CAD).


RESULTS
SA and RA recognize a similar total number of lesions (P = 0.61). The qualitative assessment of lesion characteristics and severity between modalities was comparable and lead to similar clinical decisions. Visualization of several vessel segments (diagonal, distal RCA, postero-lateral branches and posterior-descending) was superior with RA when compared to SA (P < 0.05). A QCA comparison (MLD, MLA, LL, % DS) revealed no difference between SA and RA. The volume of contrast (23.5 +/- 3.1 mL vs. 39.4 +/- 4.1; P = 0.0001), total radiation exposure (27.1 +/- 4 vs. 32.1 +/- 3.8 Gycm(2); P = 0.002) and image acquisition time (54.3 +/- 36.8 vs. 77.67 +/- 49.64 sec; P = 0.003) all favored RA.


CONCLUSIONS
Coronary lesion assessment, coronary screening adequacy, and QCA evaluations are comparable in SA and RA acquisition modalities in the diagnosis of CAD however RA decreases contrast volume, image acquisition time, and radiation exposure.
Garcia
Joel A
JA
Division of Cardiology, University of Colorado Health Sciences Center, Denver, Colorado 80262, USA.
Agostoni
Pierfrancesco
P
Green
Nathan E
NE
Maddux
James T
JT
Chen
S-Y James
SY
Messenger
John C
JC
Casserly
Ivan P
IP
Hansgen
Adam
A
Wink
Onno
O
Movassaghi
Babak
B
Groves
Bertron M
BM
Van Den Heuvel
Paul
P
Verheye
Stefan
S
Van Langenhove
Glenn
G
Vermeersch
Paul
P
Van den Branden
Frank
F
Yeghiazarians
Yerem
Y
Michaels
Andrew D
AD
Carroll
John D
JD
D000368:Aged; D002932:Cineangiography; D003287:Contrast Media; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011829:Radiation Dosage; D011857:Radiographic Image Interpretation, Computer-Assisted; D012399:Rotation; D013997:Time Factors; D014481:United States
D003287:Contrast Media