Ideal Guiding Catheter Position During Bilaterally Engaged Percutaneous Coronary Intervention.
Using a novel combined angiography computed tomography (CT) system, we evaluated the impact of the intra-aortic root position of a right coronary artery (RCA) catheter on its coaxiality. We retrospectively enrolled 19 patients who underwent CT scans during bilaterally engaged percutaneous coronary intervention. Coaxiality was defined as the angle between the RCA and the RCA catheter. The coaxiality was better when the RCA catheter was placed anterior to the left main coronary artery catheter (median 27.0° vs 53.7°, p = 0.02). The position of the RCA catheter had a significant impact on the coaxiality of it, with a coaxiality improvement ratio of 0.506 (95% confidence interval 0.294 to 0.871, p = 0.017). Three-dimensional reconstructed CT images of the right anterior oblique projection could determine the position of catheters in all cases. In conclusion, the RCA catheter should be placed anterior, rather than posterior, to the left main coronary artery catheter for better coaxiality during bilaterally engaged percutaneous coronary intervention. The right anterior oblique projection is useful for determining the catheter position.
Cardiovascular Division, Osaka National Hospital, Osaka, Japan.
Kensuke
K
Yokoi
Department of Clinical Epidemiology and Biostatistics, Osaka University Graduate School of Medicine, Suita, Japan.
Masahiko
M
Hara
Cardiovascular Division, Osaka National Hospital, Osaka, Japan. Electronic address: yellowplaque@gmail.com.
Yasunori
Y
Ueda
Department of Cardiology for International Education and Research, Osaka University Graduate School of Medicine, Suita, Japan.
Satoru
S
Sumitsuji
Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan.
Masaki
M
Awata
Department of Cardiology for International Education and Research, Osaka University Graduate School of Medicine, Suita, Japan.
Youssef K
YK
Salah
Department of Clinical Epidemiology and Biostatistics, Osaka University Graduate School of Medicine, Suita, Japan.
Daijiro
D
Kabata
Department of Clinical Epidemiology and Biostatistics, Osaka University Graduate School of Medicine, Suita, Japan.
Ayumi
A
Shintani
Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan.
Yasushi
Y
Sakata
D000368:Aged; D057785:Catheters; D017023:Coronary Angiography / Q000379:methods*; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000601:surgery; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000601:surgery*; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*