Raja Lahiri provides an overview of coronary angiography. Key points include:
- Coronary angiography is the current gold standard for visualizing the coronary arteries through X-ray imaging with contrast injection.
- The history of coronary angiography began in the 1920s-1940s with early experiments in cerebral and cardiac catheterization.
- Modern techniques involve accessing arteries typically through the femoral or radial arteries to insert a catheter for contrast injection into the coronary arteries under X-ray imaging.
- Multiple angiographic views are needed to visualize different segments of the left and right coronary arteries. Coronary angiography is used to evaluate coronary artery disease, graft patency, and left ventricular function.
Ionizing Radiation -How is Gray different from Sievert -Deterministic & Stochastic Radiation Risks -Air Kerma-Time, Distance and Shielding Principles -Dosimetry
rotablation is procedure used in complex pci with heavily calcified lesion for adequate expansion of stent.if used in indicated case and well aware of contraindication is necessary for achieving good results.
Ionizing Radiation -How is Gray different from Sievert -Deterministic & Stochastic Radiation Risks -Air Kerma-Time, Distance and Shielding Principles -Dosimetry
rotablation is procedure used in complex pci with heavily calcified lesion for adequate expansion of stent.if used in indicated case and well aware of contraindication is necessary for achieving good results.
This is a comprehensive description of coronay lesion assessment from routinely used angiography to advanced imaging modalities like IVUS/OCT including their functional significance by FFR
Diagnostic catheters for coronary angiography Aswin Rm
Overview of diagnostic catheters used in coronary angiography
Guide catheters not included
History of coronary catheters
Radial techniques and catheters
Peripheral Angioplasty / Endovascular Management of PVD - PrinciplesSaurabh Joshi
This presentation covers the principles of peripheral angioplasty with and explanation of the TASC stratification and selection of appropriate management according to current guidelines. Endovascular management of peripheral vascular disease.
This is a comprehensive description of coronay lesion assessment from routinely used angiography to advanced imaging modalities like IVUS/OCT including their functional significance by FFR
Diagnostic catheters for coronary angiography Aswin Rm
Overview of diagnostic catheters used in coronary angiography
Guide catheters not included
History of coronary catheters
Radial techniques and catheters
Peripheral Angioplasty / Endovascular Management of PVD - PrinciplesSaurabh Joshi
This presentation covers the principles of peripheral angioplasty with and explanation of the TASC stratification and selection of appropriate management according to current guidelines. Endovascular management of peripheral vascular disease.
A detailed description of ct coronary angiography and calcium scoring with various aspects regarding the preparation, procedure, limitations and a short review regarding post CABG imaging.
The Cherry Blossom season in Hunza begins in the second week of March and lasts until the end of April, varying with altitude. During this enchanting period, tourists from around the world flock to Hunza Valley to witness its transformation into a vibrant tapestry of white, pink, and green. The valley comes alive with cherry blossoms, creating a picturesque and mesmerizing landscape that captivates visitors.
About the Company:
The Cherry Blossom season in Hunza starts in the second week of March and extends until the end of April, depending on the altitude. During this enchanting period, tourists from around the globe travel to Hunza Valley to witness its transformation into a vibrant tapestry of white, pink, and green. The valley comes alive with cherry blossoms, creating a picturesque and mesmerizing landscape that captivates all who visit. For the best experience, join Hunza Adventure Tours, the top tour company in Pakistan, and immerse yourself in this breathtaking seasonal spectacle.
Exploring Montreal's Artistic Heritage Top Art Galleries and Museums to VisitSpade & Palacio Tours
Montreal boasts a vibrant artistic heritage, showcased in its top art galleries and museums. From the expansive collections at the Montreal Museum of Fine Arts to the cutting-edge exhibits at the Musée d'art contemporain, discover the city's rich cultural landscape. Experience dynamic street art, indigenous works, and contemporary pieces, reflecting Montreal's diverse and innovative art scene.
Antarctica- Icy wilderness of extremes and wondertahreemzahra82
In this presentation, we delve into the captivating realm of Antarctica, Earth's southernmost continent. This icy wilderness stands as a testament to extremes, with record-breaking cold temperatures and vast expanses of pristine ice. Antarctica's landscape is dominated by towering glaciers, colossal icebergs, and expansive ice shelves. Yet, amidst this frozen expanse, a rich tapestry of unique wildlife thrives, including penguins, seals, and seabirds, all finely attuned to survive in this harsh environment. Beyond its natural wonders, Antarctica also serves as a vital hub for scientific exploration, providing invaluable insights into climate change and the Earth's history
Discover Palmer, Puerto Rico, through an immersive cultural tour that unveils its rich history and vibrant traditions. Experience lively festivals, savor authentic cuisine, and explore local markets. Visit historical landmarks, museums, and stunning colonial architecture. Engage with friendly locals, enjoy live music, and hike scenic nature trails, all while participating in cultural workshops and discovering unique artisan crafts.
BTW UK Visa Application Process, Uk Visa complete guide, Uk Visa fees, requirements and application process. Know all about uk visa and best way to apply for the uk visa. Get to know about the requirements that allows you for the faster visa appliaction. BTW UK Visa Application Process, Uk Visa complete guide, Uk Visa fees, requirements and application process. Know all about uk visa and best way to apply for the uk visa. Get to know about the requirements that allows you for the faster visa appliaction. BTW UK Visa Application Process, Uk Visa complete guide, Uk Visa fees, requirements and application process. Know all about uk visa and best way to apply for the uk visa. Get to know about the requirements that allows you for the faster visa appliaction. BTW UK Visa Application Process, Uk Visa complete guide, Uk Visa fees, requirements and application process. Know all about uk visa and best way to apply for the uk visa. Get to know about the requirements that allows you for the faster visa appliaction. BTW UK Visa Application Process, Uk Visa complete guide, Uk Visa fees, requirements and application process. Know all about uk visa and best way to apply for the uk visa. Get to know about the requirements that allows you for the faster visa appliaction. BTW UK Visa Application Process, Uk Visa complete guide, Uk Visa fees, requirements and application process. Know all about uk visa and best way to apply for the uk visa. Get to know about the requirements that allows you for the faster visa appliaction. BTW UK Visa Application Process, Uk Visa complete guide, Uk Visa fees, requirements and application process. Know all about uk visa and best way to apply for the uk visa. Get to know about the requirements that allows you for the faster visa appliaction. BTW UK Visa Application Process, Uk Visa complete guide, Uk Visa fees, requirements and application process. Know all about uk visa and best way to apply for the uk visa. Get to know about the requirements that allows you for the faster visa appliaction. Get information in this PDF and simplyfy your visa process.
How To Talk To a Live Person at American Airlinesflyn goo
This page by FlynGoo can become your ultimate guide to connecting with a live person at American Airlines. Have you ever felt lost in the automated maze of customer service menus? FlynGoo is here to rescue you from endless phone trees and automated responses. With just a click or a call to a specific number, we ensure you get the human touch you deserve. No more frustration, no more waiting on hold - we simplify the process, making your travel experience smoother and more enjoyable.
How To Change Name On Volaris Ticket.pdfnamechange763
How to change name on Volaris ticket? This is one of the most common questions asked by travelers flying with Volaris Airlines. The mentioned details can help you with your name rectification on the airline ticket. If you are still facing difficulties call the consolidation desk at +1-800-865-1848.
During the coldest months, Italy transforms into a winter wonderland, providing visitors with a very unique experience. From the Settimana Bianca ski event to the lively Carnevale celebrations, Italy's winter festivities provide something for everyone. Enjoy hot cocoa, eat hearty comfort foods, and buy during winter deals. Explore the country's rich cultural past by participating in Settimana Bianca, and Carnevale, sipping hot chocolate, shopping during winter deals, and indulging in winter comfort foods. Visit our website https://timeforsicily.com/ for more information.
The Power of a Glamping Go-To-Market Accelerator Plan.pptxRezStream
Unlock the secrets to success with our comprehensive 8-Step Glamping Accelerator Go-To-Market Plan! Watch our FREE webinar, where you'll receive expert guidance and invaluable insights on every aspect of launching and growing your glamping business.
Discover the wonders of the Wenatchee River with a variety of river tours in Monitor, WA. Whether you're seeking thrilling whitewater rafting, peaceful kayaking, family-friendly float trips, or scenic sunset cruises, there's something for everyone. Enjoy fishing, wildlife spotting, bird watching, and more in this beautiful natural setting, perfect for outdoor enthusiasts and families alike.
LUXURY TRAVEL THE ULTIMATE TOKYO EXPERIENCE FROM SINGAPORE.pdfDiper Tour
Get off on the most luxurious Tokyo itinerary from Singapore. Experience Tokyo’s sophisticated modernism and rich tradition with first-class travel, sumptuous lodging, fine food, and special tours. Savor the finest that this energetic city has to offer for an experience that will never be forgotten.
MC INTERNATIONALS | TRAVEL COMPANY IN JHANGAshBhatt4
Experience the world with MC Internationals travel and tourism. From foreign getways to cultural concentration, we tailor unforgettable journeys for every traveler. Let us turn your dream into reality and create lasting memories. Explore with us today. #TRAVEL,COMPANY #BEST,TRAVEL,COMPANY #VISIT,VISA #EMPLOYMENT,VISA #STUDY,VISA #HAJJ,AND,UMRAH
London Country Tours, the foremost travel partner offers customized Stonehenge tours from London coming with private tour guides and direct access to the inner circles. Visit: https://www.londoncountrytours.co.uk/tour/tours-to-stonehenge-oxford/
Its running cost is among the diverse vital aspects you must consider before buying an electric scooter. Calculate the cost of getting e-scooter charge for your regular usage to calculate its economic efficiency, similar to people who investigate the mileage of petrol or diesel-driven scooters.
4 DAYS MASAI MARA WILDEBEEST MIGRATION SAFARI TOUR PACKAGE KENYABush Troop Safari
Join our 4-day Masai Mara Wildebeest Migration Safari in Kenya. Witness the incredible wildebeest migration, enjoy exciting game drives, and stay in comfortable lodges. Get up close and personal with one of nature's most amazing exhibits! Book Your Safari Today at - https://bushtroop-safaris.com/
2. Introduction
Angiography: Visualisation of the vascular bed via X-
ray/MRI with contrast injection
Conventional
CT
MRA
Conventional CAG: Current gold standard
3. History
1927
• Egas Moniz: Cerebral angiography
1929
• Werner Forssmann: Cardiac
catheterisation
1940
• Andre Cournand and Dickinson Richards:
Catheterisation and hemodynamics
4. History
Initial attempts focussed on non
selective contrast injections in
aortic root
Selective injections feared with
risk of ventricular fibrillation
based on animal studies
Transient cardiac arrest with aortic
occlusion with balloon was used to
obtain better quality images
1958: Accidental injection of
contrast in right coronary artery by
Dr. Mason Sones and his associateDr. F. Mason Sones
6. Indications
Established CAD:
To define coronary anatomy and formulate management
plan
Emergent revascularisation in STEMI
To confirm non invasive diagnosis of CAD
Left ventricular dysfunction, ventricular arrhythmias,
ambiguous non invasive test results, out of hospital
cardiac arrest survivors
Pre Surgical evaluation
7. Contraindications
No absolute contraindication
Anemia
Renal dysfunction
Active infection
High bleeding risk
Contrast Allergy
11. Contrast material
High osmolality ionic contrast media:
Not used nowadays
High incidence of adverse events
Low osmolar non ionic contrast agents:
Most commonly used agent
Well tolerated
Iso osmolar non ionic contrast agents
12.
13. Femoral
Most frequently used access site
Ease of access, lesser contrast and radiation exposure,
freedom to upgrade to bigger size sheaths
Need for immobilisation, local site complications:
main drawbacks
16. Radial
No need for immobilisation
Lower rate of local vascular complications
Increasingly being used as primary access site
Slightly higher contrast and radiation exposure with
beginners
Spasm, loops, failure to get access may require switch to
femoral route
21. Angiography techniques
Prior heparinisation
Hemodynamic monitoring (Utmost important)
Always check for pressure damping/ventricularisation
before injection
Beware of air and clots
22. Contrast Injection
Left coronary artery: 6-8ml over 2-3 seconds
Right coronary artery: 4-6ml over 2-3 seconds
Should be adequate to fill the coronary artery completely
without streaming
Excessive contrast injection should be avoided
Cine acquisition (@10fps) should continue till contrast
clears from the system
29. LMCA
Best seen in a shallow LAO
projection with slight caudal
angulation
Cranial angulation to
improve visualization of its
proximal and ostial segments.
Steep LAO caudal (also called
the spider view) lays out the
terminal left main
bifurcation.
Not helpful in the case of a
horizontally positioned heart,
in which situation a steep
RAO caudal view is
substituted.
30. LAD
No single view adequately
depicts the entire course of
the LAD.
The proximal LAD is best
visualized in steep LAO
projections with cranial
angulation, whereas the
middle and distal segments
are better seen in LAO and
RAO views with some caudal
angulation.
The best view for most of the
diagonal arteries, to include
their origin and distal
segments, is usually a steep
LAO (50 degrees) with steep
cranial (50 degrees)
angulation
31. LCX
The LCX is best seen in
caudal projections.
The proximal portion of
the LCX is usually imaged
in the RAO caudal
angulation, which also lays
out the marginal arteries.
An alternative view for the
mid segment of the LCX
and the marginal arteries is
the steep LAO caudal
(spider) view.
33. RCA The proximal segment of the
RCA is best seen in the flat LAO
angulation.
For optimal visualization of the
ostium, a steep (50 degrees)
LAO projection is preferred.
The mid segment of the RCA is
best seen in the LAO and flat
RAO projections.
The crux, or distal RCA, and the
proximal portions of the right
PDA and PLB arteries are best
seen with an AP or slight LAO
projection with 20 to 30 degrees
of cranial angulation.
The middle and distal segments
of the right PDA are best
visualized with a flat RAO
projection.
51. Flow
TIMI grade:
TIMI 0 flow (no perfusion) refers to the absence of any
antegrade flow beyond a coronary occlusion.
TIMI 1 flow (penetration without perfusion) is faint
antegrade coronary flow beyond the occlusion, with
incomplete filling of the distal coronary bed.
TIMI 2 flow (partial reperfusion) is delayed or sluggish
antegrade flow with complete filling of the distal
territory.
TIMI 3 is normal flow which fills the distal coronary bed
completely
53. Coronary anomalies
Anomalous origin
From same sinus
From different sinus
From other coronary artery
Single coronary
Aneurysms
Coronary fistulas
56. Graft Angiography
JR4: Most commonly used for various grafts
Amplatz right, LIMA catheter, dedicated bypass graft
catheters may be needed
Clips at sites of graft may be useful guides
Prior CTA gives valuable information
Root angio with pigtail to identify grafts
59. LV angiography
Not routine nowadays
Pigtail with contrast injection via power injector
Done in RAO 30 to estimate LV function and mitral
regurgitation
Assessment of LVEDP and LV to aorta gradient