X-Ray Coronary Angiography
The first experience in visualizing coronary arteries under in vivo conditions was gained in the early 1950s by nonselective, supra-aortic contrast injections [1]. Technical advances in X-ray technology, especially the advent of image intensifiers and cin
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HISTORICAL BACKGROUND . • . . • . • . • . • • • • • . .
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INDICATIONS AND CONTRAINDICATIONS FOR CORONARY
AORTIC RooT ANATOMY
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CORONARY OSTIA
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ANGIOGRAPHY . • • . • . • • • . • • • . • • • . . EQUIPMENT FOR CORONARY ANGIOGRAPHY
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CATHETERS FOR CORONARY ANGIOGRAPHY INTRAARTERIAL SHEATHS
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GUIDEWIRES • . . • • . • . . . . • . . . • . . ARTERIAL BLOOD PRESSURE RECORDINGS
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VAsCULAR AccEss FOR CoRONARY ANGIOGRAPHY CHOICE OF ARTERIAL ACCESS SITE FEMORAL ARTERY ACCESS BRACHIAL ARTERY ACCESS RADIAL ARTERY AcCESS
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RADIOGRAPHIC CONTRAST AGENTS NORMAL CORONARY ANATOMY •. ..
CORONARY ARTERIES DOMINANCE
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LEFT CORONARY ARTERY
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RIGHT CORONARY ARTERY CORONARY VEINS
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CORONARY ARTERY ANOMALIES
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CORONARY ARTERY ANOMALIES WITH HEMODYNAMIC SIGNIFICANCE
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SIGNIFICANCE
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CORONARY ARTERY MYOCARDIAL BRIDGES • CATHETERIZATION TECHNIQUES JUDKINS TECHNIQUE
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AMPLATZ TECHNIQUE • • . . . • • • . . • MULTIPURPOSE (SCHOONMAKER-KING) TECHNIQUE SONES TECHNIQUE
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NOMENCLATURE OF ANGIOGRAPHIC VIEWS RIGHT ANTERIOR OBLIQUE PROJECTIONS LEFT ANTERIOR OBLIQUE PROJECTIONS ANTEROPOSTERIOR PROJECTIONS
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LATERAL PROJECTION . . . • . • . • . . .
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The first experience in visualizing coronary arteries under in vivo conditions was gained in the early 1950s by nonselective, supra-aortic contrast injections [1]. Technical advances in X-ray technology, especially the advent of image intensifiers and cine angiography, allowed for controlled contrast injections under continuous visual control and were important prerequisites for the establishment of coronary angiography. Selective coronary angiography was pioneered by Mason Sones [2] in 1959, using a multipurpose catheter introduced from the right arm, rapidly displacing previous nonselective techniques. In 1967, Judkins (3] and Amplatz [4] independently introduced preshaped catheters for selective intubation of the coronary artery ostia via the retrograde femoral approach. Over the ensuing years, the Judkins technique was rapidly embraced because of its simplicity and high success rate and is currently used in over So % of all diagnostic coronary angiograms [5]. Further miniaturization of catheter technology and coronary angiography being increasingly performed on an outpatient basis has led to a renaissance of catheterization techniques using brachial or radial artery access. The establishment of coronary artery bypass grafting in the late 1960s required the exact definition of coronary
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STANDARD PROJECTIONS FOR CORONARY ANGIOGRAPHY • • • . . • • . • . • . • • . • CONTRAST INJECTION TECHNIQUE QUALITATIVE CORONARY ANGIOGRAPHIC INTERPRETATION LESION SEVERITY MORPHOLOGY
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CORONARY ARTERY PERFUSION
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PITFALLS OF CORONARY ANGIOGRAPHY QUANTITATIVE CORONARY ANGIOGRAPHY COMP
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