Author + information
- Viktor Kočka, MD, PhD1,2,3,
- Pascal Theriault-Lauzier, MD, PhD1,
- Tian-Yuan Xiong, MBBS, PhD1,4,
- Jeremy Ben-Shoshan, MD, PhD1,5,
- Róbert Petr, MD2,3,
- Marek Laboš, MD3,
- Jean Buithieu, MD1,
- Negareh Mousavi, MD1,
- Thomas Pilgrim, MD6,
- Fabien Praz, MD6,
- Pavel Overtchouk, MD1,
- Jean-Pierre Beaudry, MD1,
- Marco Spaziano, BSc, MD1,
- Jean-Philippe Pelletier, MD1,
- Giuseppe Martucci, MD1,
- Sonny Dandona, MD, PhD1,
- Stéphane Rinfret, MD1,
- Stephan Windecker, MD6,
- Jonathon Leipsic, MD7 and
- Nicolo Piazza, MD, PhD1,∗ ()
- 1Department of Medicine, Division of Cardiology, McGill University Health Centre, Montreal, Quebec, Canada
- 2Third Faculty of Medicine, Charles University, Prague, Czech Republic
- 3Cardiocenter, University Hospital Královské Vinohrady, Prague, Czech Republic
- 4Department of Cardiology, West China Hospital, Sichuan University, China
- 5Tel-Aviv Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- 6Department of Cardiology, Swiss Cardiovascular Center, Bern, Switzerland
- 7Department of Radiology, St. Paul Hospital, Vancouver, Canada
- ↵∗Address for Correspondence:
Nicolo Piazza, MD Division of Cardiology Department of Medicine McGill University Health Centre The Royal Victoria Hospital 1001 Boul. Décarie Montréal, Québec, Canada, H4A 3J1. Tel: (514) 934-1934, 65361 Fax: (514) 843-1491
Objectives This study aims to define the optimal fluoroscopic viewing angles of both coronary ostia and important coronary bifurcations by using three-dimensional multi-slice computed tomography data.
Background Optimal fluoroscopic projections are crucial for coronary imaging and interventions. Historically, coronary fluoroscopic viewing angles were derived empirically from experienced operators.
Methods In this analysis, we studied 100 consecutive patients who underwent computed tomography coronary angiography (CTCA) for suspected coronary artery disease. We describe a CTCA-based method to define optimal viewing angles of both coronary ostia and important coronary bifurcations to guide percutaneous coronary interventions (PCI).
Results The average optimal viewing angle for ostial left main stenting was LAO 37; CRA 22 (95% CI LAO 33-40, CRA 19-25) and for ostial right coronary stenting LAO 79; CRA 41 (95% CI LAO 74-84, CRA 37-45). Estimated mean optimal viewing angles for bifurcation stenting were as follows: left main - LAO 0; CAU 49 (95% CI RAO 8-LAO 8, CAU 43-54), left anterior descending with first diagonal branch - LAO 11; CRA 71 (95% CI RAO 6-LAO 27, CRA 66-77), left circumflex bifurcation with first marginal branch – LAO 24; CAU 33 (95% CI LAO 15-33, CAU 25-41) and posterior descending artery and posterolateral branch – LAO 44; CRA 34 (95% CI LAO 35-52 and CRA 27-41).
Conclusions CTCA can suggest optimal fluoroscopic viewing angles of coronary artery ostia and bifurcations. As the frequency of use of diagnostic CTCA increases in the future, it has the potential to provide additional information for planning and guiding PCI procedures.
- coronary arteries
- computed tomography
- coronary angiography
- percutaneous coronary intervention
Dr. Thériault-Lauzier and Dr. Piazza have been consultants for Circle Cardiovascular Imaging Inc., Calgary, AB, Canada.
All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
Dr. Kočka was supported by the European Commission: a) Operational Programme: Research, Development and Education, summons No. 17 International Mobility of Researchers, registration no. CZ.02.2.69/0.0/0.0/16_027/0008495; b) Operational Programme: Research, Development and Education, project INTERCARDIS, registration no. CZ.02.1.01/0.0/0.0/16_026/0008388 and by Charles University Research Centre Program No. UNCE/MED/002.
Tweet/handle: @nicolo_piazza ; Computed tomography can define optimal fluoroscopic views of coronary artery ostia and bifurcations. This could help with planning and guiding PCI procedures.
- Received May 11, 2020.
- Revision received June 18, 2020.
- Accepted June 19, 2020.
This article requires a subscription or purchase to view the full text. If you are a subscriber or member, click Login or the Subscribe link (top menu above) to access this article.