Dataset Information

When is rotational angiography superior to conventional single-plane angiography for planning coronary angioplasty?

ABSTRACT:

Objectives

To investigate the value of rotational coronary angiography (RoCA) in the context of percutaneous coronary intervention (PCI) planning.

Background

As a diagnostic tool, RoCA is associated with decreased patient irradiation and contrast use compared with conventional coronary angiography (CA) and provides superior appreciation of three-dimensional anatomy. However, its value in PCI remains unknown.

Methods

We studied stable coronary artery disease assessment and PCI planning by interventional cardiologists. Patients underwent either RoCA or conventional CA pre-PCI for planning. These were compared with the referral CA (all conventional) in terms of quantitative lesion assessment and operator confidence. An independent panel reanalyzed all parameters.

Results

Six operators performed 127 procedures (60 RoCA, 60 conventional CA, and 7 crossed-over) and assessed 212 lesions. RoCA was associated with a reduction in the number of lesions judged to involve a bifurcation (23 vs. 30 lesions, P?ConclusionsCompared with conventional CA, RoCA augments quantitative lesion assessment, enhances confidence in the assessment of coronary artery disease and the precise details of the proposed procedure, but does not affect X-ray dose, contrast agent volume, or procedure duration.

SUBMITTER: Morris PD

PROVIDER: S-EPMC4855622 | biostudies-literature | 2016 Mar

REPOSITORIES: biostudies-literature

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Publications

When is rotational angiography superior to conventional single-plane angiography for planning coronary angioplasty?

Morris Paul D PD Taylor Jane J Boutong Sara S Brett Sarah S Louis Amal A Heppenstall James J Morton Allison C AC Gunn Julian P JP

Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions 20150527 4

<h4>Objectives</h4>To investigate the value of rotational coronary angiography (RoCA) in the context of percutaneous coronary intervention (PCI) planning.<h4>Background</h4>As a diagnostic tool, RoCA is associated with decreased patient irradiation and contrast use compared with conventional coronary angiography (CA) and provides superior appreciation of three-dimensional anatomy. However, its value in PCI remains unknown.<h4>Methods</h4>We studied stable coronary artery disease assessment and P ...[more]

PMID: 26012725

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Project description:ObjectiveBecause there is evidence for a clinical benefit of using coronary computed tomography (CT) angiography instead of invasive coronary angiography (ICA) in patients with suspected coronary artery disease (CAD), we ascertained if patient satisfaction could represent an important barrier to implementation of coronary CT in clinical practice.Materials and methodsA total of 329 patients with suspected CAD and clinical indication for ICA were randomly assigned to undergo either CT or ICA for guiding treatment. Satisfaction for both groups was assessed by patient questionnaire completed twice, ≥24 h after CT or ICA, and at follow-up after a median of 3.7 years. Assessment included preparation, concern, comfort, helplessness, pain, willingness to undergo tests again, overall satisfaction, and preference. Pearson's chi-square test and Wilcoxon rank-sum test were used.ResultsOverall, 91% of patients undergoing CT (152/167) and 86% undergoing ICA completed assessment (140/162, p = 0.19). Patients reported being significantly better prepared for CT, less concerned about the test, and felt less helpless than during ICA (all: p < 0.001). Subjective pain (horizontal nonmarked visual analogue scale) was significantly lower for CT (6.9 ± 14.7) than for ICA (17.1 ± 22.7; p < 0.001). At follow-up, significantly more patients in the CT group reported very good satisfaction with communication of findings compared with the ICA group (p < 0.001) and 92% would recommend the institution to someone referred for the same examination.ConclusionsResults from our single-center randomized study show very good satisfaction with coronary CT compared to ICA. Thus, superior acceptance of CT should be considered in shared decision-making.Clinical relevance statementThis evaluation of patient satisfaction in a randomized study shows that patients' preference is in line with the clinical benefit provided by CT and also suggests to prefer a CT-first strategy in suspected coronary artery disease.Key points• Subjective pain was significantly lower for coronary CT angiography than for invasive coronary angiography and patients felt better prepared and less concerned about CT. • Patients were overall more satisfied with coronary CT angiography than invasive coronary angiography in a randomized controlled trial. • After a median follow-up of 3.7 years, more patients in the CT group indicated very good satisfaction with the communication of findings and with the examination itself.

Dataset Information

When is rotational angiography superior to conventional single-plane angiography for planning coronary angioplasty?

Objectives

Background

Methods

Results

Publications

When is rotational angiography superior to conventional single-plane angiography for planning coronary angioplasty?

Similar Datasets

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