Related Experiment Videos
Digital subtraction angiography as a method of screening for coronary artery disease during peripheral vascular
Insights
Digital subtraction angiography (DSA) effectively screens for coronary artery disease using aortic root injections. This method accurately identifies blockages and bypass graft issues, potentially reducing cardiac events in vascular surgery patients.
Area of Science:
- Cardiovascular Imaging
- Interventional Cardiology
- Vascular Surgery
Background:
- Myocardial infarction is a leading cause of death after peripheral vascular surgery.
- Accurate screening for coronary artery disease is crucial in these high-risk patients.
Purpose of the Study:
- To evaluate digital subtraction angiography (DSA) with aortic root injection as a screening tool for coronary artery disease.
- To assess the feasibility and accuracy of this technique in animal models and potential clinical application.
Main Methods:
- DSA with intra-arterial aortic root injection of contrast material was performed in canine models.
- The technique was tested for visualizing normal coronary anatomy, iatrogenic stenoses, occlusions, and coronary artery bypass grafts.
Main Results:
- DSA clearly demonstrated normal coronary anatomy and accurately identified induced stenoses and occlusions.
- Excellent visualization of patent coronary artery bypass grafts was achieved, with partial and near-total obstructions identified.
Conclusions:
- Aortic root injection with DSA is a feasible method for screening coronary artery disease.
- This technique can visualize coronary arteries and bypass grafts, potentially reducing mortality in patients undergoing peripheral vascular surgery.
Abstract:
Since myocardial infarction is the major cause of perioperative and postoperative death following peripheral vascular surgery, an accurate method of screening for coronary artery disease in this group of patients is needed. Digital subtraction angiography (DSA) with the use of intra-arterial aortic root injection of contrast material was evaluated as a method of screening for coronary artery disease in patients undergoing angiography for peripheral vascular disease. The feasibility of this method was demonstrated in animal experiments. Fifteen milliliters of Renografin-76 was power injected into the aortic root of seven anesthetized 20 kg mongrel dogs. Normal coronary artery anatomy was clearly demonstrated with DSA, and a series of iatrogenically created stenoses and occlusions were accurately identified. Excellent definition of patent grafts to the left anterior descending and circumflex coronary arteries was obtained in two dogs that had undergone previous coronary artery bypass grafting. A balloon occluder on one graft was used to demonstrate partial and near-total obstruction of the bypass graft. We are currently studying the use of aortic root injections using DSA to determine coronary artery disease in patients having standard angiography for peripheral vascular disease. Adequate visualization of coronary arteries and bypass grafts with only 20 ml of contrast has been obtained. The potential ability of this technique to identify and allow treatment of life-threatening coronary artery lesions in patients prior to or simultaneously with peripheral vascular surgery may result in reduced mortality.