Randomized study of the safety and clinical utility of rotational angiography versus standard angiography in the diagnosis of coronary artery disease

Abstract

This study evaluates the safety and clinical utility of rotational angiography in the diagnosis of coronary artery disease. High-speed rotational angiography is a newly available angiographic modality that gives a dynamic multiple-angle perspective of the coronary tree during a single contrast injection. We prospectively randomized 56 patients referred for diagnostic coronary angiography to either standard or rotational angiography. Contrast and radiation utilization were compared between the two groups. The number of additional cine acquisitions needed was used to determine adequacy of the diagnostic study protocol. Rotational angiography was successfully completed in all subjects. There was a 33% reduction in contrast utilization in the rotational group as compared to the standard group (35.6 +/- 12.6 vs. 52.8 +/- 10.7 ml, respectively; P < 0.0001). Additionally, there was a 28% reduction in total radiation exposure in the rotational group as compared to the standard group (39.0 +/- 18.5 vs. 53.9 +/- 23.4 Gycm(2), respectively; P = 0.01). Total whole-body radiation exposure to the primary operator was 144 mrem with rotational angiography and 170 mrem with standard angiography. Procedure time tended to be shorter for rotational angiography (353.9 +/- 146.7 vs. 396.8 +/- 165.8 s; P = 0.3). Rotational coronary angiography can be rapidly performed in any patient and provides a significant reduction in contrast and radiation utilization while at the same time providing adequate angiographic data to complement or replace standard coronary angiography in the evaluation of coronary artery disease.

Potential role of three-dimensional rotational angiography and C-arm CT for valvular repair and implantation

“…This assures that the rotations are centered and that the images are calibrated so that pixel size is known, quantitative measurements are possible, and images are appropriate for 3D reconstruction. The first randomized, controlled study comparing coronary RA with conventional angiography for diagnostic coronary exams was conducted in 2004 [2], proving RA as a valid technique with the capability to complement and potentially replace certain roles of conventional static-view coronary angiography. In coronary angiography, it has been shown that rotational angiography can reduce radiation dose and contrast loads as compared with conventional angiography [3][4][5].…”

Rotational angiography (RA) and three-dimensional imaging (3-DRA): an available clinical tool

“…Off line 3-D coronary angiography computer reconstructions have been available and their algorithms validated for standard imaging and rotational angiography [6,7]. While rotational angiography has been shown to decrease contrast and radiation dosage during diagnostic catheterizations, it has no direct advantage over standard imaging based 3-D modeling [8,9]. When rotational angiography is performed, two different FOV are often used (9 inches or 7 inches) to allow a complete representation of the coronary tree.…”

Robust Model-Based 3D/3D Fusion Using Sparse Matching for Minimally Invasive Surgery

“…C-arm CT is emerging as a novel modality that can acquire 3D CT-like volumes directly in the OR in the same coordinate system as 2D fluoroscopy, which overcomes the need for 2D/3D registration. For most procedures, the patients are older and therefore, a safe execution of the procedure is the dominating factor [3]. Some methods work directly on the C-arm CT images [4] to extract patient-specific models for procedure guidance.…”