Читать книгу Interventional Cardiology - Группа авторов - Страница 96

Flavia Caniato, Francesca Ristalli, Alessio Mattesini, Carlo Di Mario, and Gioel Gabrio Secco

Angiography has been the keystone tool to assess coronary anatomy, leading to the development of largely applied revascularization techniques such as coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI). When CABG was the only revascularization strategy, the main scope of angiography was to detect the presence of significant stenosis and to provide information on vessel distality and contrast run‐off. There was no need to be parsimonious with contrast because no further angiographic procedures were being planned. However, with the development of PCI, angiography has become far more important. In addition to clearly demonstrating the entire length of all epicardial arteries, the focus is to identify the anatomy of the lesion including its extension and the relationship with side branch vessels in order to allow correct planning of the revascularization strategy. The number of views and contrast use is restricted to the minimum required in anticipation of further contrast requirement during intervention. Therefore, angioplasty focused projections should be favored in view of standard acquisitions, carefully selecting the more informative views in order to avoid foreshortening or overlapping of the diseased vessels [1]. The main limitation of angiography is that it can only provide a limited analysis of lumen profile without providing in‐depth information about vessel wall characteristics or the composition of coronary lesions. New intracoronary imaging techniques, namely IVUS and OCT, have been developed to overcome these limitations and will be discussed in subsequent chapters.