A novel reporting approach to coronary angiography: "segmental coding system"

A new systematic reporting system for coronary angiography has been developed, which is capable of describing any visible intraluminal or extraluminal conditions with the exact coordinates.

In this method, called "segmental coding system"(SCS), the part of the artery that is located between its two subsequent branches is considered to be an "angiographic segment". Conditions are localized according to their relationship with these angiographic segments and the anatomic border of the segments (coronary ostiums, primary, secondary and tertiary branches, grafts and proximal and distal anastomosis sites). They are also described by using a special coding system that consists of letters, numbers and signs. SCS can supply the name (stenosis, occlusion, contour deformity, aneurysm, rupture, anatomical variation, existence of stent, etc.) and the exact localization (coordinates) of the condition with its properties; filling direction, and the collateral system that fills the vessel.

We applied SCS to more than 500 cineangiograpies. According to our experience, SCS provides more objective, detailed, and even correct information than the current narrative reporting system. SCS also offers many extra advantages. (a) It can describe all imaginable types of lesion combinations. (b) All of the existing conditions can be listed without missing. (c) The definitions are very precise and clear. They can easily be understood by everyone in the same way. (d) It is more advantageous on archiving, searching the database, and comparing the subsequent reports for the same patient. (e) In the future, by using specially tailored software, personal and detailed angiographic images will be reproduced from the SCS data.

By being introduced into clinical practice, we believe, SCS will prove a very useful tool for both surgeons and cardiologists.