Initial clinical experience of selective coronary angiography using one prolonged injection and a 180° rotational trajectory

Objective: Evaluate the safety of prolonged coronary injections during a rotational acquisition covering 180 degrees. Background: Rotational angiography has been adapted to coronary angiography and shown to reduce radiation and contrast exposure. Three-dimensional (3D) reconstructions and other advanced applications require imaging over a 180 degrees-arc with a single but longer injection of larger contrast volumes. Methods: Thirty patients referred for angiography were enrolled. Blood pressure (BP), heart rate (HR), symptoms, and ectopy were recorded before-and-after injections. Results: Pre and postinjection HRs for the LCA/RCA were not statistically different (LCA-pre-injection 63 +/- 13 bpm vs. LCA-post-injection 62 +/- 11 bpm, P = 0.54 and RCA-pre-injection 65 +/- 12 bpm vs. RCA-post-injection 65 +/- 10, P = 0.88). Central aortic pressure values were not statistically different for the RCA injections (RCA-systolic-pre-injection 118 +/- 14 mm Hg vs. RCA-systolic-post-injection 112 +/- 25 mm Hg, P = 0.15, and RCA diastolic-pre-injection 69 9 mm Hg vs. RCA-diastolic-post-injection 60 10 mm Hg, P = 0.88) but were statistically significant for the LCA injections (LCA systolic-pre-injection 122 +/- 19 mm Hg vs. LCA-systolic-postinjection 116 +/- 17 mm Hg, P = 0.0004, and LCA-diastolic-pre-injection 69 +/- 10 mm Fig vs. LCA-diastolic-post-injection 65 +/- 9 mm Fig, P = 0.0007). There were no symptoms or electrical events documented during or immediately post-injection. Conclusion: This study demonstrates the feasibility and safety of longer coronary injections. There were no significant HR changes, clinically insignificant pressure changes, and no adverse reactions. Additional studies will be needed to assure its safety in a larger and clinically more varied patient population. (C) 2007 Wiley-Liss, Inc.