Care relating to a coronary angiography technique that minimizes iodinated contrast administration and ionizing radiation exposure: rotational coronar
Section: Artículo Especial
How to quote
Enferm Cardiol. 2019;26(76):89-93
Authors
Ana López Roldán1, Coky Martín2, María Tornel Cerezo3, Anna Baiget Pons3, Diego Fernández Rodríguez4.
Position
1 RN. Servicio de Cardiología, Hospital Universitario Nuestra Señora de Candelaria, Universidad de La Laguna, Santa Cruz de Tenerife. 2 BSc. Servicio de Cardiología, Hospital Universitario Nuestra Señora de Candelaria, Universidad de La Laguna, Santa Cruz de Tenerife. 3 RN. Servicio de Cardiología, Hospital Universitari Arnau de Vilanova, Lleida. 4 MD, PhD. Servicio de Cardiología del Hospital Universitario Arnau de Vilanova de Lleida y del Hospital Universitario Nuestra Señora de Candelaria de Santa Cruz de Tenerife.
Contact address
Diego Fernández Rodríguez. Hospital Universitari Arnau de Vilanova. Avda. Alcalde Rovira Roure 80. 25198 LLeida
Contact email: d.fernan.2@hotmail.com
Abstract
Introduction. Rotational coronary angiography (RCA) is a modality of coronariography that allows to explore each coronary artery with a single contrast injection. The aim of this manuscript is to describe the procedure and the potential beneficial effects thereof.
Methodology. Coronary atherosclerosis is the leading cause of death in our setting, with conventional coronary angiography (CCA) being the technique of choice for its diagnosis. The progress in X-ray systems, by allowing a quick turn of the X-ray arch in both axes (cranial-caudal and right-left), has made it possible to explore each coronary artery with a single contrast injection by RCA, rather than the multiple contrast injections required by the CCA for an adequate evaluation of the coronary tree. The main benefit provided by RCA is mediated by a reduction in the amount of contrast and in the exposure to ionizing radiations, which are inherent to these procedures, thereby reducing the incidence of the two major adverse effects associated with these techniques: contrast-induced nephropathy and neoplasias secondary to radiation exposure.
Conclusion. RCA is an angiographic technique that allows to minimize iodinated contrast administration and ionizing radiation exposure, the use of which will be increased in usual clinical practice. Consequently, it is highly relevant for the medical, nursing and radiology staff to have an in-depth knowledge of the characteristics of this procedure.
Keywords:
angiography; contrast media; renal insufficiency; coronary atherosclerosis
Versión en Español
Título:
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Bibliography
1. Thiele H, Desch S, de Waha S. Acute myocardial infarction in patients with ST-segment elevation myocardial infarction : ESC guidelines 2017. Herz. 2017;42:728-38.
2. Raposeiras-Roubín S, Abu-Assi E, Ocaranza-Sánchez R, et al. Dosing of iodinated contrast volume: a new simple algorithm to stratify the risk of contrast-induced nephropathy in patients with acute coronary syndrome. Catheter Cardiovasc Interv. 2013;82:888-97. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/23362013
3. Faroux L, Blanpain T, Nazeyrollas P, et al. Reduction in exposure of interventional cardiologists to ionising radiation over a 10-year period. Int J Cardiol. 2018;259:57-9. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/29496296
4. Fernández-Rodríguez D, Anmad Shihadeh L, Martos-Maine JL, et al. Impact of rotational coronary angiography in the amount of iodinated contrast and the exposure to ionising radiations in patients undergoing invasive coronary procedures: A systematic review and meta-analysis. Arch Cardiol Mex. 2018;88:277-86.
5. Fernández-Rodríguez D, Grillo-Pérez JJ, Pérez-Hernández H, et al. Prospective evaluation of the development of contrast-induced nephropathy in patients with acute coronary syndrome undergoing rotational coronary angiography vs. conventional coronary angiography: CINERAMA study. Nefrologia. 2018;38:169-78. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/28734584
6. Gomez-Menchero AE, Diaz JF, Sanchez-Gonzalez C, Cardenal R, Sanghvi AB, Roa-Garrido J, Rodriguez-Lopez JL. Comparison of dual-axis rotational coronary angiography (XPERSWING) versus conventional technique in routine practice. Rev Esp Cardiol. 2012;65:434-39.
7. Keuffel E, McCullough PA, Todoran TM, et al. The effect of major adverse renal cardiovascular event (MARCE) incidence, procedure volume, and unit cost on the hospital savings resulting from contrast media use in inpatient angioplasty. J Med Econ. 2018;21:356-364. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/29226736
8. Loomba RS, Rios R, Buelow M, Eagam M, Aggarwal S, Arora RR. Comparison of Contrast Volume, Radiation Dose, Fluoroscopy Time, and Procedure Time in Previously Published Studies of Rotational Versus Conventional Coronary Angiography.Am J Cardiol. 2015;116:43-9. Disponible en:
https://www.ncbi.nlm.nih.gov/pubmed/25983128
9. Neumann FJ, Sousa-Uva M, Ahlsson A, et al. 2018 ESC/EACTS Guidelines on myocardial revascularization. Eur Heart J. 2018 Aug 25. doi: 10.1093/eurheartj/ehy394
10. Costa F, Ariotti S, Valgimigli M, et al. Perspectives on the 2014 ESC/EACTS Guidelines on Myocardial Revascularization : Fifty Years of Revascularization: Where Are We and Where Are We Heading? J Cardiovasc Transl Res. 2015;8:211-20. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/25986910
