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Title: A Randomized Trial Comparing Dual Axis Rotational Versus Conventional Coronary Angiography in a Population with a High Prevalence of Coronary Artery Disease
Authors: Giuberti, Rafael S. O. [UNIFESP]
Caixeta, Adriano [UNIFESP]
Carvalho, Antonio C. [UNIFESP]
Soares, Milton M. [UNIFESP]
Abreu-Silva, Erlon O. [UNIFESP]
Medina Pestana, Jose O. [UNIFESP]
Tedesco-Silva, Helio [UNIFESP]
Vaz, Maria Lucia [UNIFESP]
Genereux, Philippe
Fernandes, Rosley W. A. [UNIFESP]
Universidade Federal de São Paulo (UNIFESP)
Columbia Univ Med Ctr
Cardiovasc Res Fdn
Hosp Sacre Coeur Montreal
Issue Date: 1-Oct-2014
Publisher: Wiley-Blackwell
Citation: Journal of Interventional Cardiology. Hoboken: Wiley-Blackwell, v. 27, n. 5, p. 456-464, 2014.
Abstract: Objectives: To compare the safety, radiation dose, and contrast volume between dual axis rotational coronary angiography (DARCA) and conventional coronary angiography (CCA).Background: CCA is performed in multiple, predefined stationary views, at different angulations around the patient, for both the left and right coronary arteries. DARCA (AlluraXperSwing (TM), Philips, the Netherlands) involves a pre-set rotation of the C-arm around the patient and allows for the visualization of each coronary artery in different views, using a single automatic pump contrast injection.Methods: From November 2012 to February 2013, 201 patients were randomly assigned to either CCA (n = 100) or DARCA (n = 101). Exclusion criteria included acute coronary syndrome (ACS), prior PCI or CABG. CCAs were performed in 4 acquisition runs for the left coronary artery and 2 to 3 acquisition runs for the right coronary artery, whereas DARCAs were performed in a single run for each coronary artery.Results: Baseline demographics and clinical characteristics were similar for both groups. the overall prevalence of CAD was 77.6%. the DARCA group had a significant reduction in the amount of contrast, 60 ml (IQR: 52.5-71.5 ml) versus 76 ml (IQR: 68-87 ml), P < 0.0001; and radiation dose by Air Kerma, 269.5 mGy (IQR: 176-450.5) versus 542.1 mGy (IQR: 370.7-720.8), P < 0.0001. There were fewer patients requiring additional projections in the DARCA group: 54.0% versus 75.0%; P = 0.002.Conclusions: in a population with a high prevalence of CAD, DARCA was safe and resulted in a significant decrease in contrast volume and radiation dose.
ISSN: 0896-4327
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