We sought to compare the radiation dose, contrast volume, and procedure time between dual-axis rotational coronary angiography (DARCA) and conventional coronary angiography (CCA) techniques in a setting characterized by a prevalence of 100% suspected coronary artery disease.
Previous studies have shown a reduction in radiation dose and contrast volume using DARCA, but these results have not been replicated in coronary artery disease (CAD) populations.
All-comers, prospective, randomized, open-label trial. Cine acquisition dose-area product (DAP), cumulative Air Kerma (AK), effective dose (E), fluoroscopic time, contrast volume, AK, cine acquisition DAP (CADAP), fluoroscopic DAP (F-DAP) and total DAP were compared between DARCA and CCA groups.
We included 503 consecutive patients with suspected CAD, 252 assigned to DARCA and 251 to CCA. Stable coronary artery disease in 465 cases and non-ST elevation acute coronary syndrome in 38. Mean age: 61.88 ± 11.2 years, male gender 70.2%. DARCA arm patients showed lower total E dose (6.85 (4.55-10.83) vs. 7.91 (5.58-11.94) Sv; p = 0.0023), and cine E (3.00 (2.00-4.00) vs. 4.00 (3.00-5.00) Sv; p < 0.0001). Total DAP was also lower (40.3 (26.8-63.7) vs. 46.5 (32.8-70.2) Gycm2; p = 0.0023, as a consequence of a lower CADAP (16.3 (10.5-22.9) vs. 23.4 (17.4-32.0) Gycm2; p < 0.0001, with lower AK (367 (248-1497) vs. 497 (381-1827) mGy; p < 0.0001, with less contrast medium used (90 (60.0-106.0) vs. 100 (75.0-120.0) ml; p = 0.014.
In a population with 100% suspected coronary artery disease, DARCA reduces contrast material volume and radiation dose compared with CCA.