Coronary angiography film quality

Coronary Angiography
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General Principles Overview Historical Perspective Contraindications Appropriate Use Criteria for Revascularization Complications Technique Film Quality
Anatomy & Projection Angles
Normal Anatomy Coronary arteries Dominance Right System Left System Left Main Left Anterior Descending Circumflex Median Ramus
Anatomic Variants Separate Ostia Anomalous Origins Case Example Fistula
Projection Angles Standard Views Left Coronary Artery Right Coronary Artery
Epicardial Flow & Myocardial Perfusion
Epicardial Flow TIMI Frame Count TIMI Flow Grade TIMI Grade 0 Flow TIMI Grade 1 Flow TIMI Grade 2 Flow TIMI Grade 3 Flow TIMI Grade 4 Flow Pulsatile Flow Deceleration
Myocardial Perfusion TIMI Myocardial Perfusion Grade TMP Grade 0 TMP Grade 0.5 TMP Grade 1 TMP Grade 2 TMP Grade 3
Lesion Complexity
ACC/AHA Lesion-Specific Classification of the Primary Target Stenosis
Preprocedural Lesion Morphology Eccentricity Irregularity Ulceration Intimal Flap Aneurysm Sawtooth Pattern Length Ostial location Angulation Proximal tortuosity Degenerated SVG Calcification Total occlusion Coronary Artery Thrombus TIMI Thrombus Grade TIMI Thrombus Grade 0 TIMI Thrombus Grade 1 TIMI Thrombus Grade 2 TIMI Thrombus Grade 3 TIMI Thrombus Grade 4 TIMI Thrombus Grade 5 TIMI Thrombus Grade 6
Lesion Morphology Quantitative Coronary Angiography Definitions of Preprocedural Lesion Morphology Irregular Lesion Disease Extent Arterial Foreshortening Infarct Related Artery Restenosis Degenerated SVG Collaterals Aneurysm Bifurcation Trifurcation Ulceration
Left ventriculography
Technique Quantification of LV Function Quantification of Mitral Regurgitation

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vanessa Cherniauskas, M.D. [2]

Coronary Angiography Film Quality

• Uninterpretable

The primary endpoint cannot be analyzed secondary to exceedingly poor film exposure or quality (i.e. no images on the film, inadequate injection of contrast material, etc.).

• Poor

The primary endpoint can be analyzed but the film quality is poor secondary to under or overexposure, poor panning, poor engagement, poor contrast injection, excess collimation, partial obscuration by diaphragm. The distinction between TIMI grade one and two flow is unobtainable because the cinefilming is of inadequate duration to make the distinction.

• Average

Adequate film quality. In some, but not all views, distal panning is adequate to assess TIMI Flow Grade and/or TIMI Myocardial Perfusion Grade.

• Good

Good film quality. During most injections there is adequate panning to assess flow to the distal vasculature and collaterals if present.

• Excellent

Excellent film quality. There is adequate panning to assess flow to the distal vasculature of the infarct-related artery and collaterals if present. Dye is not injected prior to the beginning of the cinefilming.