title: A randomized trial comparing dual axis rotational versus conventional coronary angiography in a population with a high prevalence of coronary artery disease.
abstract: OBJECTIVE
  To compare the safety, radiation dose, and contrast volume between dual axis rotational coronary angiography (DARCA) and conventional coronary angiography (CCA).
  
  
  BACKGROUND
  CCA is performed in multiple, predefined stationary views, at different angulations around the patient, for both the left and right coronary arteries. DARCA (AlluraXperSwing™, Philips, the Netherlands) involves a pre-set rotation of the C-arm around the patient and allows for the visualization of each coronary artery in different views, using a single automatic pump contrast injection.
  
  
  METHODS
  From November 2012 to February 2013, 201 patients were randomly assigned to either CCA (n = 100) or DARCA (n = 101). Exclusion criteria included acute coronary syndrome (ACS), prior PCI or CABG. CCAs were performed in 4 acquisition runs for the left coronary artery and 2 to 3 acquisition runs for the right coronary artery, whereas DARCAs were performed in a single run for each coronary artery.
  
  
  RESULTS
  Baseline demographics and clinical characteristics were similar for both groups. The overall prevalence of CAD was 77.6%. The DARCA group had a significant reduction in the amount of contrast, 60 ml (IQR: 52.5-71.5 ml) versus 76 ml (IQR: 68-87 ml), P < 0.0001; and radiation dose by Air Kerma, 269.5 mGy (IQR: 176-450.5) versus 542.1 mGy (IQR: 370.7-720.8), P < 0.0001. There were fewer patients requiring additional projections in the DARCA group: 54.0% versus 75.0%; P = 0.002.
  
  
  CONCLUSIONS
  In a population with a high prevalence of CAD, DARCA was safe and resulted in a significant decrease in contrast volume and radiation dose.
authors.affiliation: Hospital do Rim; Hospital São Paulo, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Rafael S O
authors.initials: RS
authors.lastname: Giuberti
authors.forename: Adriano
authors.initials: A
authors.lastname: Caixeta
authors.forename: Antônio C
authors.initials: AC
authors.lastname: Carvalho
authors.forename: Milton M
authors.initials: MM
authors.lastname: Soares
authors.forename: Erlon O
authors.initials: EO
authors.lastname: Abreu-Silva
authors.forename: José O Medina
authors.initials: JO
authors.lastname: Pestana
authors.forename: Hélio T
authors.initials: HT
authors.lastname: Silva Júnior
authors.forename: Maria Lúcia
authors.initials: ML
authors.lastname: Vaz
authors.forename: Philippe
authors.initials: P
authors.lastname: Généreux
authors.forename: Rosley W A
authors.initials: RW
authors.lastname: Fernandes
mesh_terms: D003287:Contrast Media / Q000008:administration & dosage; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011829:Radiation Dosage
chemical_list: D003287:Contrast Media