What is 3D Rotational Angiography?

Some experiments of rotational angiography were going on decades back. Sometimes it would even end up in ventricular fibrillation due to prolonged injection of contrast which deprives myocardium of oxygenated blood. 3D rotational angiography is not that old technique, but a novel technology which can create a volumetric data set of contrast-enhanced CT like images with excellent visualization of soft tissues and airway, with spatial resolution even better than multi-detector CT or cardiac magnetic resonance imaging [1]. The single plane C-arm flat panel detector which we see in most cathlabs now-a-days, rotates around the subject over 4-5 seconds during contrast injection. It provides a 2D angiogram with 200 to 240 degrees of viewing, 3D reconstruction of which can be manipulated to view the structures from all angles in a multiplanar format. It can provide intraluminal fly-through and clipping-plane views which help endovascular assessment of stents, aneurysms, vessel wall irregularities and calcification. The dataset could even be used to generate 3D-printed models of congenital heart disease [2].

Reference

1. Kang SL, Armstrong A, Krings G, Benson L. Three-dimensional rotational angiography in congenital heart disease: Present status and evolving future. Congenit Heart Dis. 2019 Nov;14(6):1046-1057. doi: 10.1111/chd.12838. Epub 2019 Sep 4. PMID: 31483574.
2. Seckeler MD, Boe BA, Barber BJ, Berman DP, Armstrong AK. Use of rotational angiography in congenital cardiac catheterisations to generate three-dimensional-printed models. Cardiol Young. 2021 Sep;31(9):1407-1411. doi: 10.1017/S1047951121000275. Epub 2021 Feb 18. PMID: 33597057.