Abstract
Several studies have shown that dual-axis rotational coronary angiography (DARCA) reduces contrast medium volume and radiation exposure compared to conventional coronary angiography (CCA). However, there are no studies comparing the safety and usefulness of DARCA in primary percutaneous coronary intervention (PCI) for patients with ST-elevation myocardial infarction (STEMI). The aim of this study was to investigate the effects of DARCA on contrast medium volume, radiation exposure, time course of treatment, and adverse events in primary PCI for patients with STEMI. A total of 82 patients undergoing primary PCI were included in this study. Subjects were propensity matched to 41 patients in the CCA group and 41 in the DARCA group. Data were retrospectively collected from in-patient medical records and the contrast medium volume and radiation exposure (dose-area product, DAP) during the PCI procedure was compared between the two groups. Contrast medium volume [100.0 (82.5–115.0) vs 110 (102.5–127.5) ml, p = 0.018, r = 0.26] and DAP [113.4 (74.3–141.1) vs 138.1 (100.5–194.7) Gy cm2, p = 0.014, r = 0.27] were significantly lower in the DARCA group, compared with the CCA group. Door to device time (68.7 ± 26.1 vs 76.5 ± 44.2 min, p = 0.33) were comparable between the two groups. There were no adverse events requiring treatment reported in either groups. DARCA may reduce contrast medium volume and radiation exposure in primary PCI for patients with STEMI, and can be used safely, without delaying reperfusion of the infarct-related coronary artery.
Highlights
Coronary angiography plays an important role in the diagnosis and treatment of coronary artery disease since first performed by Sones in 1959 [1]
Propensity score matching was performed for the 153 patients (63 in conventional coronary angiography (CCA) group, 90 in dualaxis rotational coronary angiography (DARCA) group) in our study cohort
Baseline clinical characteristics were similar between the CCA group and the DARCA group (Table 1)
Summary
Coronary angiography plays an important role in the diagnosis and treatment of coronary artery disease since first performed by Sones in 1959 [1]. As catheter and angiographic systems have evolved over time, their safety and diagnostic accuracy have improved. Conventional coronary angiography (CCA) requires multidirectional views of both the left and right coronary arteries. It is well known that the use of contrast medium and radiation can lead to adverse events with increased use [2,3,4,5,6]. Various techniques have been devised to reduce contrast medium volume and radiation exposure while maintaining diagnostic accuracy. One of such techniques, has been utilized since 1998 [7, 8]. Coronary artery rotation imaging has since evolved to the dualaxis rotational coronary angiography (DARCA) system
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