Understanding Invasive Coronary Angiography:

What it is? Where it is? Where it goes?

🧵 w/ several (usual) projections (full video link at the end).

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The 3D model:
Coronary arteries segmentation and reconstruction of a patient with left dominance and their relationship with both ventricles (different patients in the CT and the invasive angiography but both with left dominance for an illustrative correlation). – bei Instituto Nacional de CardiologĂ­a "Ignacio Chávez"
Left coronary: LAO + Cranial.
Good exposure of the LAD and diagonal branches/bifurcations. This case also good for the PD (plus: there is a severe stenosis after the 1st Diag branch). – bei Instituto Nacional de CardiologĂ­a "Ignacio Chávez"
Left coronary: LAO + Caudal (đź•·).
Good exposure of the Left Main and proximal segments of the LAD (⤴️) and the circumflex (⤵️) (plus: the severe lesion “is gone”, now there is a wire in the LAD with a stent covering the treated lesion). – bei Instituto Nacional de CardiologĂ­a "Ignacio Chávez"
Left coronary: AP (Shallow 7 RAO) + Cranial.
Good for the Left Main and the LAD, also diagonals and in this case for the PD (plus: the same severe lesion in the LAD is also easily visible). – bei Instituto Nacional de CardiologĂ­a "Ignacio Chávez"
Left coronary: AP (Shallow 7 RAO) + Caudal.
Good for the circumflex (⤵️) and the marginal branches arising from the circumflex (the LAD with the severe lesion and the diagonals are running in the upper side of this view). – bei Instituto Nacional de CardiologĂ­a "Ignacio Chávez"
Left coronary: RAO + Cranial.
Nice to evaluate the circumflex and it marginal branches and also for the mid-distal segments of the LAD (plus: the severe stenosis still servs you as a reference for the LAD). – bei Instituto Nacional de CardiologĂ­a "Ignacio Chávez"
Left coronary: RAO + Caudal.
Good for the circumflex (⤵️) and it marginal branches, also for a good longitudinal exposure of the proximal segment of the LAD (but some overlap with the diagonals in the upper side of this view). – bei Instituto Nacional de CardiologĂ­a "Ignacio Chávez"
Right coronary: plain LAO (no cranial nor caudal).
This is a “small” non-dominant RCA, (the injection was short and the catheter quickly disengaged). Visible segments with mild proximal disease and a very small distal branch. – bei Instituto Nacional de CardiologĂ­a "Ignacio Chávez"
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