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Dual-axis Rotational Coronary Angiography Versus Conventional Coronary Angiography: A Randomized Comparison

M. Hell, Melanie D. Gilg, J. Roether, F. Blachutzik, S. Achenbach, C. Schlundt
Published 2020 · Medicine

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Background Dual-axis of rotational coronary angiography (RA), with one single cine acquisition during continuous C-arm motion along a pre-described path, is an alternative to conventional coronary angiography (CA). We assessed the performance of RA versus CA in a modern, experienced cath lab setting. Methods Sixty-seven patients with suspected coronary artery disease undergoing invasive coronary angiography were randomized to CA ( n  = 35) or dual-axis RA ( n  = 32). CA was performed with four left and two right coronary artery acquisitions with manual contrast medium injection. In RA, one cine acquisition each was performed for the left (5 projections) and right coronary artery (3 projections) with a fixed amount of contrast medium applied by a power injector. In both groups, single cine acquisitions in additional angulations were performed to fully interpret the coronary system, if necessary. Procedural parameters and outcome were compared. Results Mean age was 63 ± 12 years (64% males). Six additional projections were required in the RA group compared to 13 in the CA group ( p  = 0.173). Fluoroscopy duration (CA: 3 ± 3 min, RA: 3 ± 2 min, p  = 0.748) and dose area product (CA: 1291 ± 761 µGym 2 , RA: 1476 ± 679 µGym 2 , p  = 0.235) did not differ significantly between both groups. For CA, the amount of contrast medium (42 ± 13 vs. 46 ± 8 ml, p  = 0.022) and procedure time (8 ± 5 vs. 11 ± 3 min, p  < 0.001) were significantly lower. No major adverse event occurred during hospital stay. Conclusions Dual-axis RA represents a feasible and safe alternative method to CA for obtaining coronary angiograms. However, no superiority was observed when performed by an experienced interventionalist with a modern system.
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