Coronary artery tortuosity

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Coronary Angiography

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Anatomy & Projection Angles

Normal Anatomy

Coronary arteries
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Epicardial Flow & Myocardial Perfusion

Epicardial Flow

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Myocardial Perfusion

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Lesion Complexity

ACC/AHA Lesion-Specific Classification of the Primary Target Stenosis

Preprocedural Lesion Morphology

Eccentricity
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Ulceration
Intimal Flap
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Proximal tortuosity
Degenerated SVG
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Lesion Morphology

Quantitative Coronary Angiography
Definitions of Preprocedural Lesion Morphology
Irregular Lesion
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Infarct Related Artery
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Collaterals
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Left ventriculography

Technique
Quantification of LV Function
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vanessa Cherniauskas, M.D. [2], Mohamed Moubarak, M.D. [3]

Synonyms and keywords: Serpentine coronary artery

Overview

Coronary tortuosity (CT) is a common finding in coronary angiography settings. Although the clinical importance of coronary tortuosity are unclear, the importance of CT comes from the possibility of reducing the coronary blood supply, through the reduced coronary perfusion pressure, as a result to this kinking and tortuosity, distal to the tortuous point of the coronary artery, which may leading to ischemia.[1]

Definition

Although coronary artery tortuosity still has unclear fixed definition, this phenomenon described as a two following 180°turns of a major epicardial artery.[2]

Pathophysiology

Coronary artery tortuosity pathophysiology is still unclear, and it is believed that it is a result of an arterial remodeling as a result of elastin degeneration in the arterial wall.[2] Elastin degeneration may occur with age, atherosclerosis, hypertension, aneurysms, ectasias, and diabetes mellitus.[3]

Epidemiology and Demographics

Diagnosis

Coronary Angiography

Clinical Significance

Treatment

Example

References

  1. Zegers ES, Meursing BT, Zegers EB, Oude Ophuis AJ (2007). "Coronary tortuosity: a long and winding road". Neth Heart J. 15 (5): 191–5. PMC 1877966. PMID 17612682.
  2. 2.0 2.1 Panduranga P, Riyami AA (2011). "Serpentine coronary arteries: in a patient with apical hypertrophic cardiomyopathy". Tex Heart Inst J. 38 (5): 594–5. PMC 3231533. PMID 22163145.
  3. Xie X, Wang Y, Zhu H, Zhou H, Zhou J (2013). "Impact of coronary tortuosity on coronary blood supply: a patient-specific study". PLoS One. 8 (5): e64564. doi:10.1371/journal.pone.0064564. PMC 3656900. PMID 23691249.


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