Usefulness of dual-axis rotational coronary angiography in primary percutaneous coronary intervention for patients with
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ORIGINAL ARTICLE
Usefulness of dual‑axis rotational coronary angiography in primary percutaneous coronary intervention for patients with ST‑elevation myocardial infarction Hideaki Suwa1,2 · Yota Koyabu1 · Taichi Adachi1 · Akira Kawai3 · Kazuhiko Kotani4 · Shigeru Toyoda2 · Teruo Inoue2 · Toru Kato2,5 Received: 3 August 2020 / Accepted: 20 November 2020 © The Author(s) 2020
Abstract Several studies have shown that dual-axis rotational coronary angiography (DARCA) reduces contrast medium volume and radiation exposure compared to conventional coronary angiography (CCA). However, there are no studies comparing the safety and usefulness of DARCA in primary percutaneous coronary intervention (PCI) for patients with ST-elevation myocardial infarction (STEMI). The aim of this study was to investigate the effects of DARCA on contrast medium volume, radiation exposure, time course of treatment, and adverse events in primary PCI for patients with STEMI. A total of 82 patients undergoing primary PCI were included in this study. Subjects were propensity matched to 41 patients in the CCA group and 41 in the DARCA group. Data were retrospectively collected from in-patient medical records and the contrast medium volume and radiation exposure (dose-area product, DAP) during the PCI procedure was compared between the two groups. Contrast medium volume [100.0 (82.5–115.0) vs 110 (102.5–127.5) ml, p = 0.018, r = 0.26] and DAP [113.4 (74.3–141.1) vs 138.1 (100.5–194.7) Gy c m2, p = 0.014, r = 0.27] were significantly lower in the DARCA group, compared with the CCA group. Door to device time (68.7 ± 26.1 vs 76.5 ± 44.2 min, p = 0.33) were comparable between the two groups. There were no adverse events requiring treatment reported in either groups. DARCA may reduce contrast medium volume and radiation exposure in primary PCI for patients with STEMI, and can be used safely, without delaying reperfusion of the infarct-related coronary artery. Keywords ST-elevation myocardial infarction · Primary percutaneous coronary intervention · Contrast medium · Radiation exposure · Rotational coronary angiography
Introduction * Hideaki Suwa [email protected] 1
Department of Cardiovascular Medicine, National Hospital Organization Tochigi Medical Center, 1‑10‑37, Nakatomatsuri, Utsunomiya, Tochigi 320‑8580, Japan
2
Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, Tochigi, Japan
3
Department of Radiology, National Hospital Organization Tochigi Medical Center, Utsunomiya, Tochigi, Japan
4
Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan
5
Department of Clinical Research, National Hospital Organization Tochigi Medical Center, Utsunomiya, Tochigi, Japan
Coronary angiography plays an important role in the diagnosis and treatment of coronary artery disease since first performed by Sones in 1959 [1]. As catheter and angiographic systems have evolved over time, their safety and diagnostic accuracy have also improved. However
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