New Developments in Quantitative Coronary Arteriography

ISBN-13: 9789401070829 / Angielski / Miękka / 2011 / 302 str.

Johan H. C. Reiber; P. W. Serruys

Opis

There are few techniques that have influenced therapeutic strategies in modem cardiology to a similar extent as coronary arteriography. Bypass surgery as well as transluminal coronary angioplasty would not have been possible without coronary angiography serving as a 'midwife' in their evolu tion. Despite the widespread and long-standing use in clinical practice, however, the interpretation of coronary angiograms has not changed very much since the early days. Most angiogr s are still reviewed in a visual and semi-quantitative and thus often very subjective way. In the face of an almost exploding field for interventional catheterization including thrombolysis, balloon dilatation, and other rapidly evolving techniques for transluminal revascularization or recanalization, a more detailed and quantitative analysis of coronary arteriograms is urgently required. In addition to the delineation of coronary morphology, we need dynamic and functional information about flow and perfusion to understand the physiological significance of anatomic abnormalities. Coronary arteriography contains and can provide most of this information. With the application of appropriate techniques, it can be made available in the catheterization laboratory even during the patient's investiga tion, thus facilitating and improving clinical decision making. Objective and reproducible analysis will furthermore enhance our understanding about the pathophysiology of coronary disease."

Spis treści

Methodological Developments in Coronary Arterial Stenosis Quantitation.- 1. Digital imaging systems for coronary angiography.- 2. Optimal biplane imaging of coronary segments with computed triple orthogonal projections.- 3. Accurate densitometric quantification requires strict attention to the physical characteristics of X-ray imaging.- 4. Morphologic and densitometric quantitation of coronary stenoses; an overview of existing quantitation techniques.- 5. Intravenous digital coronary angiography — a review of technical considerations and recent results.- 6. Assessment of the anatomic and functional severity of coronary arterial stenosis: new measuring techniques using high-frequency epicardial echocardiography and Doppler ultrasound.- Validations and Clinical Applications of Quantitative Coronary Arteriography.- 7. On the accuracy of densitometric measurements of coronary artery stenosis based on Lambert-Beer’s absorption law.- 8. Morphologic and physiologic validation of quantitative coronary arteriography utilizing digital methods.- 9. Comparison of automated edge detection and videodensitometric quantitative coronary arteriography.- 10. Issues of validation in quantitative coronary angiography.- 11. Early regression and late progression in coronary artery lesions in the first 3 months following coronary angioplasty.- 12. How to assess the immediate results of PTCA. Should we use pressure gradient, flow reserve or minimal luminal cross-sectional area?.- Assessment of Coronary Flow and Myocardial Perfusion.- 13. Theoretical and practical aspects of digital angiography for quantitative coronary flow studies.- 14. Three-dimensional reconstruction and flow measurements of coronary arteries using multi-view digital angiography.- The Current Role of Coronary Angioscopy.- 15. Coronary angioscopy during cardiac catheterization and surgery.- 16. The angioscopic view of atherosclerotic cardiovascular disease.- The Stent, a Breakthrough?.- 17. Percutaneously implantable endo-coronary prosthesis.- 18. A coronary endoprosthesis to prevent restenosis and acute occlusion after percutaneous angioplasty: one and a half year of clinical experience.- Index of subjects.