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CORONARY ANGIOGRAPHY


INTRODUCTION
sTANDARD VIEWS
ANGIOGRAPHY
LEFT CORONARY SYSTEM
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RIGHT CORONARY SYSTEM

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
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Normal left coronary artery viewed in the PA projection with 35° cranial angulation
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Left coronary angiogram viewed with 30°
RAO and 30° cranial angulation delineating the course of the LAD
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Left coronary angiogram viewed with 40° LAO and 30° cranial angulation
viewing the LAD and diagonal branch bifurcation
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SPIDER VIEW: LAO caudal view (LAO 40°, caudal 30°) visualizing the bifurcation of the MLC, the
proximal Cx, and LAD
Picture
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 
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LCA - LAO (90°) straight (lateral)
LAO (90°) straight (lateral)
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LCA - LAO (45°) cranial (30°)
LAO (45°) cranial (30°)
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LCA - AP cranial (30°)
AP  cranial (30°)
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LCA - RAO (30°) cranial (30°)
RAO (30°) cranial (30°)
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LCA - AP straight
AP straight
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