SAFETY AND EFFICACY OF DUAL MOTION ROTATIONAL CORONARY ANGIOGRAPHY



Joel A. Garcia, M.D., Orlando Health, Orlando, FL, USA

Background: Cardiac catheterization via standard angiography (SA) requires several angiograms while rotational coronary angiography (RA) employs the use of automated gantry acquisitions (LAO to RAO with a fixed cranial or caudal angulation) permitting complete visualization of the entire coronary tree via two injections of the left (LCA) (cranial and caudal) and one of the right coronary tree (RCA). XperSwing dual-axis rotational coronary angiography (DARCA) is a novel acquisition method wherein the gantry automatically rotates both LAO/RAO and cranial/caudal in one cine permitting complete visualization of a coronary tree with a single injection (Figure 1). We sought to compare DARCA to SA with respect to time, contrast and radiation dose.

Methods: 15 patients underwent SA and DARCA for both coronary trees. Contrast, dose-area product (DAP) and time (mean ±SD) were recorded for each and compared using a Student’s t-test. For DARCA, blood pressure (BP), heart rate (HR), symptoms and ectopy were recorded for each prolonged coronary injection.

Results: DARCA significantly reduced the amount of contrast used (28.9±4.2 vs.55.3±12ml; p=0.0002), radiation dose (23.9±6.3 vs. 38.5±11.7 Gy/cm2: p=0.0003) and procedural time (158.5±40.2 vs. 221.9±61.5 seconds; p=0.0028) when compared to SA. There were no significant changes in BP, HR nor development of symptoms/ectopy during DARCA.

Conclusion: DARCA is a novel, safe and effective angiographic acquisition technique which significantly reduces contrast, radiation exposure and procedural time when compared to SA.