The safety and feasibility of dual axis rotational angiography for the diagnosis of coronary artery disease in aged Chinese patients

Objective: To evaluate the clinical safety and feasibility of dual-axis rotational coronary angiography (XperSwing) in diagnosing coronary artery disease in aged Chinese patients through comparing it with standard coronary angiography. Methods: During the period from April 2011 to December 2012, a total of consecutive 151 patients with an age ≥ 65 years underwent diagnostic coronary angiography at authors' hospital. The patients were randomly divided into the standard angiography group (n = 75) and XperSwing group (n = 76). The used dose of contrast, radiation exposure dose and operation time of each patient were recorded. Besides, the occurrence of procedure-related symptoms and arrhythmia during the procedure was recorded, and the blood pressure (BP), heart rate (HR) and creatinine level immediately before-and-after the procedure were estimated. The number of additional acquisition needed to be performed was used to evaluate the efficacy of the two methods. Results: Coronary angiography was successfully accomplished in all patients of the two groups, and no significant difference in the number of additional acquisition existed between the two groups (P > 0.05). The used dose of contrast in XperSwing group was reduced by 44% when compared with that in the standard angiography group, i.e. (29.28 ± 5.06) ml vs (52.02 ± 12.05) ml, (P < 0.001); and the radiation exposure dose in XperSwing group was reduced by 50% when compared with that in the standard angiography group, i.e. (11383.60 ± 4114.52) mGycm² vs. (22755.97 ± 11239.22) mGycm², (P < 0.001). No statistically significant differences in the occurrence of procedure-related symptoms and arrhythmia during the procedure, in the operation time as well as in the postoperative changes of BP and HR existed between the two groups (P > 0.05). No contrast-induced nephropathy occurred in both groups, although the difference in postoperative changes of creatinine level between the two groups was statistically significant (P < 0.05). Conclusion: This study indicates that in diagnosing coronary artery disease in aged Chinese patients, dual-axis rotational coronary angiography is more safe and effective than conventional coronary angiography, as XperSwing can significantly reduce the contrast dose and radiation exposure for the patients. (authors)