Improved diagnosis in coronary cinearteriography with routine use of 110 degrees oblique views and cranial and caudal angulations. Comparison with standard transverse oblique views in 100 patients.

Conventionally mounted X-ray systems for coronary cinearteriography limit angulation of the X-ray beam to the transverse plane of the patient, and use of the motorized cradle restricts rotation to 60 degrees to 70 degrees. These limitations of available projections seriously hamper adequate examination of the coronary arteries. With use of the Siemen's Cardoskop-U, which was designed to overcome this problem, the coronary arteries of 100 consecutive patients were examined with standard oblique projections, and in addition with cranial and caudal angulated oblique and 110 degrees oblique projections. These arteriograms were independently examined by two expert observers. In approximately 20 percent of patients the additional views unmasked lesions that would otherwise have been missed. In a further 34 percent the diagnosis was significantly improved because the full extent of a lesion was revealed, overlap of branches was avoided or the degree of an eccentric stenosis was upgraded. In 4 of 12 patients with apparently normal arteriograms in standard projections, lesions were unmasked by the additional views.