Группа авторов

Interventional Cardiology


Скачать книгу

++ ++ – – LAD dist + + +++ + – +++ – ++ LAD/DG ++ + – ++ +++ – – – LCX prox + +++ +++ – – – – – LCX dist + + ++ +++ ++ + ++ – OM bifurc ++ +++ ++ – – – + – RCA prox – – – + +++ – ++ – RCA mid – – – – + +++ ++ +++ RCA dist/crux – – – +++ +++ – ++ – PDA – – – +++ ++ – + ++ PLV + – – +++ ++ + + – LIMA anast + – – – – +++ – –

      – not recommended; + occasionally useful; ++ very useful; +++ ideal.

      AP, anteroposterior; LAD, left anterior descending; LAO, left anterior oblique; LCX, left circumflex; LIMA, left internal mammary artery; OM, obtuse marginal; PDA, posterior descending artery; PLV, posterior left ventricular; RAO, right anterior oblique; RCA, right coronary artery.

View Good for visualizing Limitations
Combination 1
AP (5–10° RAO) LMS (ostium and main shaft) Overlap on LMS bifurcation and sometimes LMS ostium with left coronary sinus
Lateral Mid and distal LAD, mid Cx Potentially high radiation dose to operator, usually limited view of proximal LAD, patient’s arms need to be above head to visualize posterior arteries, often overlap diagonals/LAD
RAO cranial Proximal and mid LAD, distal Cx Test injections can be required to adjust angulation to ensure diagonals are above LAD, overlap with dominant Cx, and position of the diaphragm
RAO caudal Circumflex and distal LAD
Combination 2
LAO caudal LMS bifurcation, proximal LAD and proximal circumflex Potentially a higher radiation dose to the patient, poor quality images sometimes in large patients
LAO cranial Mid LAD, origin of diagonals, proximal and mid Cx Patient required to hold in inspiration during acquisition to elongate the proximal LAD
AP cranial Proximal and mid LAD, distal Cx Steep cranial angulation required can be a problem for patients with cervical spine fixation
RAO caudal Circumflex and distal LAD, sometimes LAD ostium

      AP, anteroposterior; Cx, circumflex; LAD, left anterior descending; LAO, left anterior oblique; LMS, left main stem; RAO, right anterior oblique.

      Right‐sided views

      Two perpendicular views are advocated for the RCA, usually LAO and right anterior oblique (RAO). However, it is frequently impossible to exclude disease at or beyond the crux without an additional view with cranial angulation (e.g. PA cranial or LAO cranial).

      Optimal views for each coronary segment