Angled views in the evaluation of the right coronary artery

The use of cranial and caudal angulated views in the angiographic evaluation of the right coronary artery (RCA) was assessed in 61 patients. Each patient had a standard LAO and RAO view, followed by one or more angled views. The standard LAO view showed the area about the origin of the posterior descending artery (PD0) adequately in 33 of 46 patients (&2%), and the mild and distal portions of the posterior descending artery (PDm&d) adequately in 26/46 (56%). The standard RAO view showed the PDO adequately in only 17/46 (37%) and the PDm&d adequately in 41/46 (89%). With the LAO cranial view, however, the PDO was seen well in 45/46 (98%), and PDm&d was seen well in 44/46 (96%). The RAO angled views, although of more limited utility, also afforded improved visualization of the distal segments of the RCA. We recommend the use of angled views in the evaluation of the right coronary artery, as these views, particularly the LAO cranial view, afford improved visualization of the distal segments of the RCA.