title: When is rotational angiography superior to conventional single-plane angiography for planning coronary angioplasty?
abstract: OBJECTIVE
  To investigate the value of rotational coronary angiography (RoCA) in the context of percutaneous coronary intervention (PCI) planning.
  
  
  BACKGROUND
  As a diagnostic tool, RoCA is associated with decreased patient irradiation and contrast use compared with conventional coronary angiography (CA) and provides superior appreciation of three-dimensional anatomy. However, its value in PCI remains unknown.
  
  
  METHODS
  We studied stable coronary artery disease assessment and PCI planning by interventional cardiologists. Patients underwent either RoCA or conventional CA pre-PCI for planning. These were compared with the referral CA (all conventional) in terms of quantitative lesion assessment and operator confidence. An independent panel reanalyzed all parameters.
  
  
  RESULTS
  Six operators performed 127 procedures (60 RoCA, 60 conventional CA, and 7 crossed-over) and assessed 212 lesions. RoCA was associated with a reduction in the number of lesions judged to involve a bifurcation (23 vs. 30 lesions, P < 0.05) and a reduction in the assessment of vessel caliber (2.8 vs. 3.0 mm, P < 0.05). RoCA improved confidence assessing lesion length (P = 0.01), percentage stenosis (P = 0.02), tortuosity (P < 0.04), and proximity to a bifurcation (P = 0.03), particularly in left coronary artery cases. X-ray dose, contrast agent volume, and procedure duration were not significantly different.
  
  
  CONCLUSIONS
  Compared with conventional CA, RoCA augments quantitative lesion assessment, enhances confidence in the assessment of coronary artery disease and the precise details of the proposed procedure, but does not affect X-ray dose, contrast agent volume, or procedure duration.
authors.affiliation: Department of Cardiovascular Science, University of Sheffield, United Kingdom.|Department of Cardiology, Sheffield Teaching Hospitals, Sheffield, United Kingdom.|Insigneo Institute for In Silico Medicine, Sheffield, United Kingdom.
authors.forename: Paul D
authors.initials: PD
authors.lastname: Morris
authors.affiliation: Department of Cardiovascular Science, University of Sheffield, United Kingdom.
authors.forename: Jane
authors.initials: J
authors.lastname: Taylor
authors.affiliation: Department of Cardiovascular Science, University of Sheffield, United Kingdom.
authors.forename: Sara
authors.initials: S
authors.lastname: Boutong
authors.affiliation: Department of Cardiology, Sheffield Teaching Hospitals, Sheffield, United Kingdom.
authors.forename: Sarah
authors.initials: S
authors.lastname: Brett
authors.affiliation: Department of Cardiology, Sheffield Teaching Hospitals, Sheffield, United Kingdom.
authors.forename: Amal
authors.initials: A
authors.lastname: Louis
authors.affiliation: Department of Cardiology, Sheffield Teaching Hospitals, Sheffield, United Kingdom.
authors.forename: James
authors.initials: J
authors.lastname: Heppenstall
authors.affiliation: Department of Cardiology, Sheffield Teaching Hospitals, Sheffield, United Kingdom.
authors.forename: Allison C
authors.initials: AC
authors.lastname: Morton
authors.affiliation: Department of Cardiovascular Science, University of Sheffield, United Kingdom.|Department of Cardiology, Sheffield Teaching Hospitals, Sheffield, United Kingdom.|Insigneo Institute for In Silico Medicine, Sheffield, United Kingdom.
authors.forename: Julian P
authors.initials: JP
authors.lastname: Gunn
mesh_terms: D000368:Aged; D003287:Contrast Media / Q000008:administration & dosage; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000628:therapy*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000628:therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D062645:Percutaneous Coronary Intervention; D011237:Predictive Value of Tests; D011829:Radiation Dosage; D000069079:Radiation Exposure; D011857:Radiographic Image Interpretation, Computer-Assisted; D012720:Severity of Illness Index
chemical_list: D003287:Contrast Media
keywords: coronary angiography; percutaneous coronary intervention; rotational coronary angiography