A Randomized Trial Comparing Dual Axis Rotational Versus Conventional Coronary Angiography in a Population with a High Prevalence of Coronary Artery Disease

作者：Giuberti Rafael S O; Caixeta Adriano^*; Carvalho Antonio C; Soares Milton M; Abreu Silva Erlon O; Medina Pestana Jose O; Silva Junior Helio T; Vaz Maria Lucia; Genereux Philippe; Fernandes Rosley W A

来源：Journal of Interventional Cardiology, 2014, 27(5): 456-464.

DOI：10.1111/joic.12148

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.

• 出版日期2014-10