Safety and efficacy of dual-axis rotational coronary angiography vs. standard coronary angiography.
OBJECTIVE
To determine the safety and efficacy of dual-axis rotational coronary angiography (DARCA) by directly comparing it to standard coronary angiography (SA).


BACKGROUND
Standard coronary angiography (SA) requires numerous fixed static images of the coronary tree and has multiple well-documented limitations. Dual-axis rotational coronary angiography (DARCA) is a new rotational acquisition technique that entails simultaneous LAO/RAO and cranial/caudal gantry movement. This technological advancement obtains numerous unique images of the left or right coronary tree with a single coronary injection. We sought to assess the safety and efficacy of DARCA as well as determine DARCA's adequacy for CAD screening and assessment.


METHODS
Thirty patients underwent SA following by DARCA. Contrast volume, radiation dose (DAP) and procedural time were recorded for each method to assess safety. For DARCA acquisitions, blood pressure (BP), heart rate (HR), symptoms and any arrhythmias were recorded. All angiograms were reviewed for CAD screening adequacy by two independent invasive cardiologists.


RESULTS
Compared to SA, use of DARCA was associated with a 51% reduction in contrast, 35% less radiation exposure, and 18% shorter procedural time. Both independent reviewers noted DARCA to be at least equivalent to SA with respect to the ability to screen for CAD.


CONCLUSIONS
DARCA represents a new angiographic technique which is equivalent in terms of image quality and is associated with less contrast use, radiation exposure, and procedural time than SA.
Klein
Andrew J
AJ
Division of Cardiology, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado, USA.
Garcia
Joel A
JA
Hudson
Paul A
PA
Kim
Michael S
MS
Messenger
John C
JC
Casserly
Ivan P
IP
Wink
Onno
O
Hattler
Brack
B
Tsai
Thomas T
TT
Chen
S Y James
SY
Hansgen
Adam
A
Carroll
John D
JD
D001794:Blood Pressure; D003120:Colorado; D003287:Contrast Media; D017023:Coronary Angiography / Q000009:adverse effects / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology; D004562:Electrocardiography; D005260:Female; D006339:Heart Rate; D006787:Hospitals, Veterans; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D015588:Observer Variation; D011237:Predictive Value of Tests; D011829:Radiation Dosage; D011857:Radiographic Image Interpretation, Computer-Assisted; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D012399:Rotation; D013997:Time Factors; D014283:Triiodobenzoic Acids
D003287:Contrast Media; D014283:Triiodobenzoic Acids; C044834:iodixanol