The Effectiveness and Safety between Monoplane and Biplane Imaging During Coronary Angiographies

Avoiding unnecessary radiation exposure is the main issue during coronary angiography. Herein, we aimed to investigate whether performing coronary angioplasties with monoplane or biplane imaging most effectively reduces radiation load and shortens the procedure time.

We retrospectively enrolled 294 patients who required either coronary angiography or coronary angioplasty. They were divided into groups of only diagnostic angiography, one-, two- or three-vessel diseases. The fluoroscopy dose-area product (DAP), skin dose, fluoroscopy and procedure time were recorded.

Among the studied patients, 148 received the procedures with monoplane imaging. Compared with the radiation exposure in the monoplane group, there were significant increases in DAP and skin dose in those who received biplane imaging independently of the number of lesions. This phenomenon was also observed in the patients receiving either diagnostic angiography only or coronary interventions. In addition, there were no significant differences in contrast volume and procedure time between the monoplane and biplane groups. Notably, the average fluoroscopy time in those who received biplane imaging was significantly longer than in those who received monoplane imaging in the one- and two-vessel groups, while there were no significant differences in the diagnostic angiography only and three-vessel diseases groups.

Our findings indicated that using monoplane imaging resulted in lesser radiation exposure and similar procedure times in coronary diagnostic and interventional settings compared to using biplane imaging. This observation should be verified in prospective randomized studies.