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Optimal fluoroscopic viewing angles for stenting of the coronary aorto-ostial lesions
Affiliations- Department of Cardiac and Vascular Surgery, Medical University of Gdansk, Poland
- Department of Pediatric Cardiology and Congenital Heart Diseases, Medical University of Gdansk, Poland
- Department of Radiology, Medical University of Gdansk, Poland
- First Chair and Depar tment of Cardiology, Medical University of Warsaw, Poland
- First Department of Cardiology, Medical University of Gdansk, Poland
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Abstract
Background: Long-term results after stenting aorto-coronary ostial lesions (AOL) are worse than those achieved in non-ostial locations. AOL interventions still pose a substantial challenge for interventional cardiologists. The aim of the study was to determine the optimal fluoroscopic viewing angles of the left and right coronary ostia, based on multislice computed tomography (MSCT) data.
Methods: Cardiac MSCT exams of 30 patients with clinical suspicion of coronary artery disease were analyzed. En face angles of both coronary ostia, as well as their optimal projection curves, were determined by 2 independent observers in a standard Dicom viewer, without any additional, specialized software add-ons, using a systematic, step-by-step approach. Spatial relations between the ostial plane and the aorta were also assessed.
Results: The average en face angle of the left coronary ostium was RAO 23°, CAU 45°; for the right coronary ostium RAO 18°, CRA 5°. The mean inter-observer differences for the en face angles of the left and right coronary arteries were 5° and 7°, respectively.
Conclusions: Multislice computed tomography data provide precise spatial information on the orientation of the coronary ostia and their relation to the aortic root. Their utilization for determining the patient-specific viewing angle may substantially facilitate percutaneous coronary interventions in AOL.
Abstract
Background: Long-term results after stenting aorto-coronary ostial lesions (AOL) are worse than those achieved in non-ostial locations. AOL interventions still pose a substantial challenge for interventional cardiologists. The aim of the study was to determine the optimal fluoroscopic viewing angles of the left and right coronary ostia, based on multislice computed tomography (MSCT) data.
Methods: Cardiac MSCT exams of 30 patients with clinical suspicion of coronary artery disease were analyzed. En face angles of both coronary ostia, as well as their optimal projection curves, were determined by 2 independent observers in a standard Dicom viewer, without any additional, specialized software add-ons, using a systematic, step-by-step approach. Spatial relations between the ostial plane and the aorta were also assessed.
Results: The average en face angle of the left coronary ostium was RAO 23°, CAU 45°; for the right coronary ostium RAO 18°, CRA 5°. The mean inter-observer differences for the en face angles of the left and right coronary arteries were 5° and 7°, respectively.
Conclusions: Multislice computed tomography data provide precise spatial information on the orientation of the coronary ostia and their relation to the aortic root. Their utilization for determining the patient-specific viewing angle may substantially facilitate percutaneous coronary interventions in AOL.
Keywords
aorto-ostial lesions, coronary intervention, optimal projection curves, multislice computed tomography, cardiovascular imaging
About this articleTitle
Optimal fluoroscopic viewing angles for stenting of the coronary aorto-ostial lesions
Journal
Issue
Article type
Original Article
Pages
831-841
Published online
2021-08-02
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5906
Article views/downloads
538
DOI
Pubmed
Bibliographic record
Cardiol J 2021;28(6):831-841.
Keywords
aorto-ostial lesions
coronary intervention
optimal projection curves
multislice computed tomography
cardiovascular imaging
Authors
Radosław Targoński
Jarosław Meyer-Szary
Bartosz Baścik
Edyta Szurowska
Aleksandra Gąsecka
Dariusz Jagielak
Miłosz J. Jaguszewski
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