Читать книгу Interventional Cardiology - Группа авторов - Страница 107

The circumflex ostium can be clearly seen together with the LMS bifurcation in the LAO caudal view. Occasionally, eccentric ostial lesions not clearly seen in other views can be delineated in the RAO cranial view although steep angulation may be required. The RAO caudal is the most useful diagnostic view for the circumflex and can clearly define lesions in the ostium, proximal, and mid vessel as well as the bifurcations and obtuse marginals. To obtain a working view with improved image quality by eliminating overlap with the diaphragm and reduced X‐ray attenuation, the view can be modified to AP caudal with only 10–15° rightward angulation. RAO or LAO with cranial angulation can be required to view lesions in the distal circumflex when the RAO caudal is suboptimal. If the circumflex is dominant, the LAO cranial or AP cranial views may open up the distal bifurcation and elongate the posterior descending artery. Optimal angiographic views for specific segments in the circumflex are shown in Figure 4.8a.