Panoramic Coronary Angiography》.pdfVIP

JACC Vol. 31, No. 4 871 March 15, 1998:871–7 Panoramic Coronary Angiography GIORGIO TOMMASINI, MD,* ALBERTO CAMERINI, MD,† ANTONIO GATTI, MD,‡ GIORGIO DERCHI, MD,‡ ALESSANDRO BRUZZONE,§ CARLO VECCHIO, MD‡ Genoa and Arenzano, Italy Objectives. We describe a new imaging technique for coronary conventional and the new technique with quantitative measure- angiography. ments of the severity of the stenoses, the final diagnosis was Background. The conventional approach to coronary angiogra- identical in 65. In no case was a stenosis detected only by the phy exploits static perspective imaging over multiple cardiac conventional approach. However, in 31 patients the new technique cycles, using a limited number of empirically selected views. This permitted identification of 34 critical stenoses (79 8% [mean approach entails both lack and redundancy of information and SD]) either underestimated (61 3% n 24, p 0.001) or may result in suboptimal visualization of the individual lesion, undetected (21 22%, n 10, p 0.001) in the standard contributing to diagnostic inaccuracy. projections. In a further 28 cases, 33 subcritical lesions (60 5%) Methods. We developed a new imaging technique exploiting were visualized in the rotational images but were insignificant dynamic perspective, obtained by transverse 180° rotation of the C (24 22% p 0.001) in the standard projections. In five arm of a conventional angiographic unit during standard selective addit