Understanding Invasive Coronary Angiography:
What it is? Where it is? Where it goes?
🧵 w/ several (usual) projections (full video link at the end).
#CardioEd #CardioTwitter #RadialFirst @PCRonline
@INC_CathLab @EduardoAArias1 @moisesjimenezs @sergiopatronMD
The 3D model:
Coronary arteries segmentation and reconstruction of a patient with left dominance and their relationship with both ventricles (different patients in the CT and the invasive angiography but both with left dominance for an illustrative correlation).
Left coronary: LAO + Cranial.
Good exposure of the LAD and diagonal branches/bifurcations. This case also good for the PD (plus: there is a severe stenosis after the 1st Diag branch).
Left coronary: LAO + Caudal (🕷).
Good exposure of the Left Main and proximal segments of the LAD (⤴️) and the circumflex (⤵️) (plus: the severe lesion “is gone”, now there is a wire in the LAD with a stent covering the treated lesion).
Left coronary: AP (Shallow 7 RAO) + Cranial.
Good for the Left Main and the LAD, also diagonals and in this case for the PD (plus: the same severe lesion in the LAD is also easily visible).
Left coronary: AP (Shallow 7 RAO) + Caudal.
Good for the circumflex (⤵️) and the marginal branches arising from the circumflex (the LAD with the severe lesion and the diagonals are running in the upper side of this view).
Left coronary: RAO + Cranial.
Nice to evaluate the circumflex and it marginal branches and also for the mid-distal segments of the LAD (plus: the severe stenosis still servs you as a reference for the LAD).
Left coronary: RAO + Caudal.
Good for the circumflex (⤵️) and it marginal branches, also for a good longitudinal exposure of the proximal segment of the LAD (but some overlap with the diagonals in the upper side of this view).
Right coronary: plain LAO (no cranial nor caudal).
This is a “small” non-dominant RCA, (the injection was short and the catheter quickly disengaged). Visible segments with mild proximal disease and a very small distal branch.
Full video here:
@threadreaderapp unroll
Share this Scrolly Tale with your friends.
A Scrolly Tale is a new way to read Twitter threads with a more visually immersive experience.
Discover more beautiful Scrolly Tales like this.