The Cardiac Catheterization Laboratory for Coronary Angioplasty

Abstract

Optimal performance of percutaneous transluminal coronary angioplasty (PTCA) requires radiological equipment capable of meeting the special demands of this interventional procedure. These demands, which influence equipment selection, may be summarized as follows: Abstract co OrderedList

• 1. Satisfactory visualization of the coronary arterial tree on a live TV fluoro­scopic screen by means of small-volume contrast material delivered at a low flow rate through coaxial catheter systems: necessary for safe manipulation of guide- wire and balloon catheter to reach and cross the lesion, especially in tortuous ar­teries with superposition and in large subjects.

• 2. Playback of video tape recording of coronary arteriograms, forward and reverse, at 30 frames/s, in slow motion and in freeze-frame, with fidelity ap­proaching cine film quality: necessary for evaluation of coronary pathology in emergency situations and for assessment of the adequacy of dilatation, especially as dilated lesions may have more complex anatomical features.

• 3. Display of high-quality stationary TV images: necessary for displaying guide shots for route mapping.

• 4. Facility allowing rapid projection changes, including cranial and caudal views: to assist in directing the guidewire into the desired branches, to ensure cor­rect placement of guidewires and dilatation catheters across the lesion, and to provide optimal visualization of the lesion before and after PTCA.

• 5. Cine films of highest possible quality, showing fine angiographic details of coronary anatomy: angiographic selection criteria for PTCA require detailed morphology of the lesions; accurate quantitation of the results of PTCA also re­quires high-quality cine films.