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Published online: 2021-08-02
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Optimal fluoroscopic viewing angles for stenting of the coronary aorto-ostial lesions

Radosław Targoński, Jarosław Meyer-Szary, Bartosz Baścik, Edyta Szurowska, Aleksandra Gasecka, Dariusz Jagielak, Miłosz J. Jaguszewski
DOI: 10.5603/CJ.a2021.0080
·
Pubmed: 34355782

open access

Ahead of print
Original articles
Published online: 2021-08-02

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.

Conclusion: 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.

Conclusion: 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.

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Keywords

aorto-ostial lesions, coronary intervention, optimal projection curves, multislice computed tomography, cardiovascular imaging

About this article
Title

Optimal fluoroscopic viewing angles for stenting of the coronary aorto-ostial lesions

Journal

Cardiology Journal

Issue

Ahead of print

Article type

Original Article

Published online

2021-08-02

DOI

10.5603/CJ.a2021.0080

Pubmed

34355782

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 Gasecka
Dariusz Jagielak
Miłosz J. Jaguszewski

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