Usefulness of Dual-Axis Rotational Angiography versus Conventional Angiography in Clinical Practice
Section: Artículos Científicos
Authors
Leonor Ortega Fernández1, María Jesús Basanta Castro2, Clara Jiménez Serrano2, Susana Miranda Castaño2, Raúl Franco Gutiérrez3
Position
1 Diplomada universitaria de Enfermería. Enfermera en la Unidad de Hemodinámica e Imagen del Servicio de Cardiología, Hospital Universitario Lucus Augusti.2 Diplomada universitaria de Enfermería. Enfermera en la Unidad de Hemodinámica del Servicio de Cardiología, Hospital Universitario Lucus Augusti.3 Facultativo Especialista de Área de Cardiología, Servicio de cardiología Hospital Universitario Lucus Augusti. Doctor en Ciencias de la Salud por la Universidad da Coruña.
Contact address
Leonor Ortega Fernández. Servicio de Cardiología. Hospital Universitario Lucus Augusti. Avenida Doctor Ulises Romero, 1. 27003 Lugo
Contact email: leonor.ortega.fernandez@sergas.es
Abstract
Introduction and objective. Coronary angiography is the gold standard technique for studying coronary artery disease; however, it is necessary to find methods that reduce the amount of contrast and radiation administered in conventional angiography. Dual-axis rotational angiography allows the visualization from different angles of each coronary artery with a single injection of contrast, versus the five injections needed in the conventional technique. The aim of this study is to compare the rotational technique with the conventional one by analyzing the amount of contrast administered, the radiation dosage, the duration of the procedure and the hospital stay.
Material and methods. Observational, analytical, longitudinal and retrospective study of a cohort of 145 consecutive patients undergoing diagnostic coronary angiography between 01/01/2015 and 30/03/2016 at our centre.
Results. 42 (29.0%) subjects underwent dual-axis rotational angiography. Statistically significant differences were objectified in the volume of contrast administered (p < 0.01) and the duration of the procedure (p = 0.014) in favour of rotational angiography. There were no significant differences either in the dosage of radiation administered or in the average stay. In the subgroup of subjects with less than 3 additional projections, differences were found in all parameters, with the exception of the average stay.
Conclusions. Dual-axis rotational angiography allows to reduce significantly the dosage of contrast and the duration of the procedure with respect to conventional angiography. In the subgroup of subjects with less than 3 projections, a reduction of the dosage of radiation was also found.
Keywords:
coronary angiography; coronary artery disease; contrast mediaradiation dosage
Versión en Español
Título:
Utilidad de la angiografía rotacional de doble eje frente a la convencional en la práctica clínica
Artículo completo no disponible en este idioma / Full article is not available in this language
Bibliography
1. Baumgartner H, Falk V, Bax JJ, De Bonis M, Hamm C, Holm PJ, et al. 2017 ESC/EACTS Guidelines for the management of valvular heart disease. European heart journal. 2017;38(36):2739-91.
2. Roffi M, Patrono C, Collet JP, Mueller C, Valgimigli M, Andreotti F, et al. 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC). European heart journal. 2016;37(3):267-315.
3. Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). European heart journal. 2018;39(2):119-77.
4. Martín-Moreiras J, Cruz-Gonzalez I, Cascón-Bueno M. Anatomía Coronaria. Proyecciones angiográficas. En: Martin Moreiras J, Cruz González I, editores. Manual de hemodinámica e intervencionismo coronario. 1ª edición. España: Pulso Ediciones; 2008. p. 57 - 72.
5. Schwartz JN, Kong Y, Hackel DB, Bartel AG. Comparison of angiographic and postmortem findings in patients with coronary artery disease. The American journal of cardiology. 1975;36(2):174-8.
6. Galbraith JE, Murphy ML, de Soyza N. Coronary angiogram interpretation. Interobserver variability. Jama. 1978;240(19):2053-6.
7. Marenzi G, Assanelli E, Campodonico J, Lauri G, Marana I, De Metrio M, et al. Contrast volume during primary percutaneous coronary intervention and subsequent contrast-induced nephropathy and mortality. Annals of internal medicine. 2009;150(3):170-7.
8. Laskey WK, Jenkins C, Selzer F, Marroquin OC, Wilensky RL, Glaser R, et al. Volume-to-creatinine clearance ratio: a pharmacokinetically based risk factor for prediction of early creatinine increase after percutaneous coronary intervention. Journal of the American College of Cardiology. 2007;50(7):584-90.
9. Neumann FJ, Sousa-Uva M, Ahlsson A, Alfonso F, Banning AP, Benedetto U, et al. 2018 ESC/EACTS Guidelines on myocardial revascularization. European heart journal. 2019;40(2):87-165.
10. Karatzis EN, Danias PG. Exposure to ionizing radiation from cardiovascular imaging and therapeutic procedures may be a considerable unrecognized risk for subsequent cancer development. Journal of the American College of Radiology : JACR. 2008;5(6):694-5.
11. Gerber TC, Carr JJ, Arai AE, Dixon RL, Ferrari VA, Gomes AS, et al. Ionizing radiation in cardiac imaging: a science advisory from the American Heart Association Committee on Cardiac Imaging of the Council on Clinical Cardiology and Committee on Cardiovascular Imaging and Intervention of the Council on Cardiovascular Radiology and Intervention. Circulation. 2009;119(7):1056-65.
12. Tommasini G, Camerini A, Gatti A, Derchi G, Bruzzone A, Vecchio C. Panoramic coronary angiography. Journal of the American College of Cardiology. 1998;31(4):871-7.
13. Akhtar M, Vakharia KT, Mishell J, Gera A, Ports TA, Yeghiazarians Y, et al. Randomized study of the safety and clinical utility of rotational vs. standard coronary angiography using a flat-panel detector. Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions. 2005;66(1):43-9.
14. Smida W, Sideris G, Stratiev V, Logeart D, Ouadhour A, Tarragano F, et al. [Rotational coronary angiography]. Archives des maladies du coeur et des vaisseaux. 2007;100(11):895-900.
15. Garcia JA, Agostoni P, Green NE, Maddux JT, Chen SY, Messenger JC, et al. Rotational vs. standard coronary angiography: an image content analysis. Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions. 2009;73(6):753-61.
16. 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. The American journal of cardiology. 2015;116(1):43-9.
17. Klein AJ, Garcia JA, Hudson PA, Kim MS, Messenger JC, Casserly IP, et al. Safety and efficacy of dual-axis rotational coronary angiography vs. standard coronary angiography. Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions. 2011;77(6):820-7.
18. Hudson PA, Klein AJ, Kim MS, Wink O, Hansgen A, Casserly IP, et al. A novel dual-axis rotational coronary angiography evaluation of coronary artery disease--case presentation and review. Clinical cardiology. 2010;33(7):E16-9.
19. Liu HL, Jin ZG, Yang SL, Luo JP, Ma DX, Liu Y, et al. Randomized study on the safety and efficacy of dual-axis rotational versus standard coronary angiography in. Chinese medical journal. 2012;125(6):1016-22.
20. Gomez-Menchero AE, Diaz JF, Sanchez-Gonzalez C, Cardenal R, Sanghvi AB, Roa-Garrido J, et al. Comparison of dual-axis rotational coronary angiography (XPERSWING) versus conventional technique in routine practice. Revista espanola de cardiologia (English ed). 2012;65(5):434-9.
21. Grech M, Debono J, Xuereb RG, Fenech A, Grech V. A comparison between dual axis rotational coronary angiography and conventional coronary angiography. Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions. 2012;80(4):576-80.
22. Di Serafino L, Turturo M, Lanzone S, Marano M, Scognamiglio G, Trimarco B, et al. Comparison of the Effect of Dual-Axis Rotational Coronary Angiography Versus Conventional Coronary Angiography on Frequency of Acute Kidney Injury, X-Ray Exposure Time, and Quantity of Contrast Medium Injected. The American journal of cardiology. 2018;121(9):1046-50.
23. Yasar AS, Perino AC, Dattilo PB, Casserly IP, Carroll JD, Messenger JC. Comparison of a safety strategy using transradial access and dual-axis rotational coronary angiography with transfemoral access and standard coronary angiography. Journal of interventional cardiology. 2013;26(5):524-9.
24. Farshid A, Chandrasekhar J, McLean D. Benefits of dual-axis rotational coronary angiography in routine clinical practice. Heart and vessels. 2014;29(2):199-205.
25. Giuberti RS, Caixeta A, Carvalho AC, Soares MM, Abreu-Silva EO, Pestana JO, et al. A randomized trial comparing dual axis rotational versus conventional coronary angiography in a population with a high prevalence of coronary artery disease. Journal of interventional cardiology. 2014;27(5):456-64.
26. Liu H, Jin Z, Deng Y, Jing L. Dual-axis rotational coronary angiography can reduce peak skin dose and scattered dose: a phantom study. Journal of applied clinical medical physics. 2014;15(4):4805.
27. Unzue-Vallejo L, Delcan-Domínguez JL, Alegría-Barrero A, Medina-Peralta J, Rodríguez-Rodrigo FJ, Rodríguez-López JL. Coronary lesions quantification with dual-axis rotational coronary angiography. Cardiovascular revascularization medicine: including molecular interventions. 2013;14(1):37-40.
28. Jin ZG, Zhang ZQ, Jing LM, Wei YJ, Zhang J, Luo JP, et al. Correlation between dual-axis rotational coronary angiography and intravascular ultrasound in a coronary lesion assessment. The international journal of cardiovascular imaging. 2017;33(2):153-60.
29. Fernandez-Rodriguez D, Anmad Shihadeh L, Martos-Maine JL, Couto-Comba P, Quijada-Fumero A, Pimienta R, 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]. Archivos de cardiologia de Mexico. 2018;88(4):277-86.
30. Roriz R, de Gevigney G, Finet G, Nantois-Collet C, Borch KW, Amiel M, et al. [Comparison of iodixanol (Visipaque) and ioxaglate (Hexabrix) in coronary angiography and ventriculography: a double-blind randomized study]. Journal de radiologie. 1999;80(7):727-32.
