CORONARY ANGIOGRAPHY
left coronary system
LEFT MAIN STEM
- Best seen in PA view or very shallow oblique projection (either RAO or LAO)
LEFT ANTERIOR DESCENDING CORONARY ARTERY
- RAO or PA view
- Steep LAO view (40°) with severe cranial angulation (40°) for LAD and Diagonal bifurcation
- LAO 40°, caudal 40° (spider view) for bifurcation of LMS, proximal circumflex and LAD and at times distal LAD.
CIRCUMFLEX CORONARY ARTERY
- RAO 20° or 30° angulation with 20°-30° causal angulation
Normal left coronary artery viewed in the PA projection with 35° cranial angulation
Left coronary angiogram viewed with 30°
RAO and 30° cranial angulation delineating the course of the LAD
RAO and 30° cranial angulation delineating the course of the LAD
Left coronary angiogram viewed with 40° LAO and 30° cranial angulation
viewing the LAD and diagonal branch bifurcation
viewing the LAD and diagonal branch bifurcation
SPIDER VIEW: LAO caudal view (LAO 40°, caudal 30°) visualizing the bifurcation of the MLC, the
proximal Cx, and LAD
proximal Cx, and LAD
Selective left coronary angiogram viewed with 30° RAO and 20° caudal angulation viewing the circumflex artery
VISUALIZATION OF NORMAL LCA
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LCA - RAO (30°) straight
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LCA - RAO (30°) caudal (30°)
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LCA - AP caudal (30°)
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LCA - LAO (50°) caudal (30°)
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LCA - LAO (60°) straight
LCA - LAO (90°) straight (lateral)
LAO (90°) straight (lateral)
LCA - LAO (45°) cranial (30°)
LAO (45°) cranial (30°)
LCA - AP cranial (30°)
AP cranial (30°)
LCA - RAO (30°) cranial (30°)
RAO (30°) cranial (30°)
LCA - AP straight
AP straight