{"id":45572,"date":"2021-05-16T12:28:35","date_gmt":"2021-05-16T06:58:35","guid":{"rendered":"https:\/\/johnsonfrancis.org\/professional\/?p=45572"},"modified":"2021-05-16T12:28:35","modified_gmt":"2021-05-16T06:58:35","slug":"coronary-angiographic-views","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/coronary-angiographic-views\/","title":{"rendered":"Coronary angiographic views"},"content":{"rendered":"<p><iframe loading=\"lazy\" width=\"560\" height=\"315\" src=\"https:\/\/www.youtube.com\/embed\/m1NnkEL6fFg\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen=\"\"><\/iframe><\/p>\n<h2><span style=\"color: #008000;\">Coronary angiographic views<\/span><\/h2>\n<p>Coronary angiography is done in multiple projections or views to get a three dimensional idea of the coronary lesions. Some regions of the coronary arteries may appear foreshortened in certain views so that true length of the lesion may not be appreciated. Actual severity of eccentric stenosis can be ascertained only by multiple orthogonal views. Even though there are several conventional views for coronary angiography, unusual angulations may be needed in an individual case to guide coronary interventions. Often a test shot is given before the actual cine run to see if the branches are overlapping or not.<\/p>\n<p>Common projections used in coronary angiography are left anterior oblique (LAO), right anterior oblique (RAO), postero-anterior (PA or AP), and lateral views. In addition to these, varying degrees of cranial or caudal angulations can be added to these views. In general, proximal parts of the major vessels are best seen in caudal projections.<\/p>\n<p><span style=\"color: #0000ff;\"><strong>Views for left coronary angiography<\/strong><\/span>&nbsp;<\/p>\n<p><em><span style=\"color: #0000ff;\"><strong>Spider view or LAO caudal view<\/strong><\/span><\/em> is often the first view taken during coronary angiography. This view is useful in visualising the left main coronary artery and its bifurcation into left anterior descending (LAD) coronary artery and left circumflex (LCX) coronary artery. LAO angulation may vary from 40-50\u00ba and caudal angulation 25-40\u00ba [1].<\/p>\n<figure id=\"attachment_34963\" aria-describedby=\"caption-attachment-34963\" style=\"width: 1200px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-34963 size-full\" src=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2012\/08\/Spider-view.jpg\" sizes=\"auto, (max-width: 1200px) 100vw, 1200px\" srcset=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2012\/08\/Spider-view.jpg 1200w, https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2012\/08\/Spider-view-293x300.jpg 293w, https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2012\/08\/Spider-view-1001x1024.jpg 1001w, https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2012\/08\/Spider-view-768x786.jpg 768w\" alt=\"Spider view - LAO caudal view of left coronary angiogram\" width=\"1200\" height=\"1228\"><figcaption id=\"caption-attachment-34963\" class=\"wp-caption-text\">Spider view &#8211; LAO caudal view of left coronary angiogram<\/figcaption><\/figure>\n<p>LAO caudal view of left coronary angiogram resembles a spider and hence the term spider view.&nbsp; LMCA: left main coronary artery; LCX: left circumflex coronary artery (lesion in LCX marked by yellow arrow); LAD: left anterior descending coronary artery; Early OM: early obtuse marginal branch of the LCX. From the LMCA bifurcation, LAD is seen towards the catheter side and LCX towards the opposite side in this view. Dye (contrast) reflux into the aorta from LMCA is seen. Absence of dye reflux would mean left main ostial disease or rarely spasm.<\/p>\n<figure id=\"attachment_45583\" aria-describedby=\"caption-attachment-45583\" style=\"width: 700px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-45583\" src=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2021\/05\/Left-coronary-angiogram-in-LAO-caudal-view2.jpg\" alt=\"Left coronary angiogram in LAO caudal view\" width=\"700\" height=\"660\"><figcaption id=\"caption-attachment-45583\" class=\"wp-caption-text\">Left coronary angiogram in LAO caudal view<\/figcaption><\/figure>\n<p>This a left coronary angiogram in LAO caudal view in another case. JL: Judkins left coronary catheter. Difference in the orientation of coronaries could be due to anatomical variations as well as mild changes in angulations used. X-ray penetration will be less in LAO caudal view, especially in obese individuals. In this view mid segment of LAD is foreshortened and hence this view should not be used during angioplasty of mid LAD. But proximal region of LAD is visualised well. Proximal and mid segments of LCX are well seen in this view.<\/p>\n<div style=\"width: 480px;\" class=\"wp-video\"><video class=\"wp-video-shortcode\" id=\"video-45572-1\" width=\"480\" height=\"360\" loop autoplay preload=\"metadata\" controls=\"controls\"><source type=\"video\/mp4\" src=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2021\/05\/Left-coronary-angiogram-in-LAO-caudal-view.mp4?_=1\" \/><a href=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2021\/05\/Left-coronary-angiogram-in-LAO-caudal-view.mp4\">https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2021\/05\/Left-coronary-angiogram-in-LAO-caudal-view.mp4<\/a><\/video><\/div>\n<p>Video of left coronary angiogram in LAO caudal view is shown above, with annotation of branches in a still frame.<\/p>\n<p><em><span style=\"color: #0000ff;\"><strong>RAO caudal view<\/strong> <\/span><\/em>is another common view for the left coronary angiogram. Some operators use this as the first view. Usual angulation is 30-40\u00ba to the right. But shallower views may be used sometimes to reduce respiratory movements. Sufficient caudal angulation to separate out the proximal portions of LAD and LCX is used. Proximal and mid portions of LCX and bifurcation of marginal branches are seen. It is a good view for the distal LAD. Diagonal and septal branches may superimpose on the proximal and mid LAD in this view.<\/p>\n<figure id=\"attachment_34931\" aria-describedby=\"caption-attachment-34931\" style=\"width: 1200px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-34931 size-full\" src=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2012\/09\/Tight-OM-Lesion-RAO-caudal-view.jpg\" sizes=\"auto, (max-width: 1200px) 100vw, 1200px\" srcset=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2012\/09\/Tight-OM-Lesion-RAO-caudal-view.jpg 1200w, https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2012\/09\/Tight-OM-Lesion-RAO-caudal-view-300x250.jpg 300w, https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2012\/09\/Tight-OM-Lesion-RAO-caudal-view-1024x852.jpg 1024w, https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2012\/09\/Tight-OM-Lesion-RAO-caudal-view-768x639.jpg 768w\" alt=\"Left coronary angiogram in RAO caudal view\" width=\"1200\" height=\"998\"><figcaption id=\"caption-attachment-34931\" class=\"wp-caption-text\">Left coronary angiogram in RAO caudal view<\/figcaption><\/figure>\n<p>Left coronary angiogram in RAO caudal view showing a tight lesion in the obtuse marginal (OM) branch of the left circumflex (LCX) coronary artery. LAD: left anterior descending coronary artery. The OM lesion is marked by the blue arrow and is seen in the proximal portion of the obtuse marginal, which is a major branch of the left circumflex.<\/p>\n<figure id=\"attachment_45595\" aria-describedby=\"caption-attachment-45595\" style=\"width: 700px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-45595\" src=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2021\/05\/lca-rao-caudal1.jpg\" alt=\"Left coronary angiogram in RAO caudal view\" width=\"700\" height=\"670\"><figcaption id=\"caption-attachment-45595\" class=\"wp-caption-text\">Left coronary angiogram in RAO caudal view<\/figcaption><\/figure>\n<p>This is a left coronary angiogram in RAO caudal view from another case. Distal LAD is seen well in this case. It can be seen that diagonal and septal branches are overlapping the mid LAD, as mentioned earlier.&nbsp;<\/p>\n<p><em><span style=\"color: #0000ff;\"><strong>AP (PA) cranial view<\/strong><\/span><\/em> is ideal for most lesions in the proximal and mid LAD. A cranial angulation of 40\u00ba shows the diagonal and septal branches in opposite directions, well separated from the LAD.&nbsp;<\/p>\n<figure id=\"attachment_37711\" aria-describedby=\"caption-attachment-37711\" style=\"width: 1200px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-37711 size-full\" src=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2009\/06\/Left-coronary-angiogram-in-PA-cranial-view.png\" sizes=\"auto, (max-width: 1200px) 100vw, 1200px\" srcset=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2009\/06\/Left-coronary-angiogram-in-PA-cranial-view.png 1200w, https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2009\/06\/Left-coronary-angiogram-in-PA-cranial-view-274x300.png 274w, https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2009\/06\/Left-coronary-angiogram-in-PA-cranial-view-937x1024.png 937w, https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2009\/06\/Left-coronary-angiogram-in-PA-cranial-view-768x840.png 768w\" alt=\"Left coronary angiogram in PA cranial view\" width=\"1200\" height=\"1312\"><figcaption id=\"caption-attachment-37711\" class=\"wp-caption-text\">Left coronary angiogram in PA cranial view<\/figcaption><\/figure>\n<p>Left coronary angiogram in PA cranial view showing a proximal plaque (arrow) in LAD, in this case a recanalized vessel after anterior wall myocardial infarction. Septal and diagonal (Diag) branches of LAD are also seen. Almost the whole extent of the LAD is seen well. Proximal left circumflex is foreshortened in this view.<\/p>\n<figure id=\"attachment_25514\" aria-describedby=\"caption-attachment-25514\" style=\"width: 500px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-25514 size-full\" src=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2009\/06\/lca-rao-cranial.jpg\" sizes=\"auto, (max-width: 500px) 100vw, 500px\" srcset=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2009\/06\/lca-rao-cranial.jpg 500w, https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2009\/06\/lca-rao-cranial-300x284.jpg 300w, https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2009\/06\/lca-rao-cranial-60x57.jpg 60w\" alt=\"Left coronary angiogram in RAO cranial view\" width=\"500\" height=\"474\"><figcaption id=\"caption-attachment-25514\" class=\"wp-caption-text\">Left coronary angiogram in RAO cranial view<\/figcaption><\/figure>\n<p>Rightward angulation (<em><strong><span style=\"color: #0000ff;\">RAO cranial<\/span><\/strong><\/em>) is useful in reducing the overlap of proximal LAD by the vertebral spine and the catheter. It may be noted that in both cranial views, the diaphragmatic shadow goes high up into the field.&nbsp;<\/p>\n<div style=\"width: 480px;\" class=\"wp-video\"><video class=\"wp-video-shortcode\" id=\"video-45572-2\" width=\"480\" height=\"360\" loop autoplay preload=\"metadata\" controls=\"controls\"><source type=\"video\/mp4\" src=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2021\/05\/Complex-LAD-Lesion-In-RAO-Cranial-View-1.mp4?_=2\" \/><a href=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2021\/05\/Complex-LAD-Lesion-In-RAO-Cranial-View-1.mp4\">https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2021\/05\/Complex-LAD-Lesion-In-RAO-Cranial-View-1.mp4<\/a><\/video><\/div>\n<p>Video of left coronary angiogram in RAO cranial view showing a complex lesion in the LAD. The LAD can be seen wrapping around the apex (type III LAD). Type I LAD will stop short of the apex and type II will reach up to the apex.<\/p>\n<p><em><strong><span style=\"color: #0000ff;\">LAO cranial view <\/span><\/strong><\/em>straightens out the proximal and mid LAD. Diagonal branches are seen on the same side as the obtuse marginal branches. Septal perforators are seen to the opposite side [2].<\/p>\n<figure id=\"attachment_25515\" aria-describedby=\"caption-attachment-25515\" style=\"width: 498px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-25515 size-full\" src=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2009\/06\/lca-lao-cranial1.jpg\" sizes=\"auto, (max-width: 498px) 100vw, 498px\" srcset=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2009\/06\/lca-lao-cranial1.jpg 498w, https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2009\/06\/lca-lao-cranial1-262x300.jpg 262w\" alt=\"Left coronary angiogram in left anterior oblique (LAO) cranial view\" width=\"498\" height=\"571\"><figcaption id=\"caption-attachment-25515\" class=\"wp-caption-text\">Left coronary angiogram in LAO cranial view<\/figcaption><\/figure>\n<p>In the left coronary angiogram in LAO cranial view shown above, OM branches of LCX are seen overlapping the spine. Diagonals are seen running down between the spine and the LAD. Septal branches are seen on the opposite side, but almost parallel to the LAD.<\/p>\n<p><strong><em><span style=\"color: #0000ff;\">Lateral view<\/span><\/em>&nbsp;<\/strong>is seldom used and ideally requires the positioning of the hands above the head to avoid superimposition of patient&#8217;s arms. But this requirement is not there when the field of interest is in the distal part of the LAD which is anterior. The same applies to visualisation of the anastomosis between the left internal mammary artery and LAD.<\/p>\n<figure id=\"attachment_32750\" aria-describedby=\"caption-attachment-32750\" style=\"width: 1200px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-32750 size-full\" src=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2016\/11\/LIMA-LAD-1.jpg\" sizes=\"auto, (max-width: 1200px) 100vw, 1200px\" srcset=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2016\/11\/LIMA-LAD-1.jpg 1200w, https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2016\/11\/LIMA-LAD-1-281x300.jpg 281w, https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2016\/11\/LIMA-LAD-1-958x1024.jpg 958w, https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2016\/11\/LIMA-LAD-1-768x821.jpg 768w\" alt=\"LIMA to LAD coronary bypass graft in lateral view\" width=\"1200\" height=\"1283\"><figcaption id=\"caption-attachment-32750\" class=\"wp-caption-text\">LIMA to LAD coronary bypass graft&nbsp;in lateral view<\/figcaption><\/figure>\n<p>The image above has been darkened a bit by post processing to visualize the LIMA and LAD well. Since it was an injection into the left subclavian artery just near the LIMA ostium, the contrast density was a bit lower than that of a superselective LIMA injection. The sternal wires indicate the post sternotomy status. Distal flow into the LAD is good. Retrograde flow from the anastomotic site into the proximal part of LAD is also seen.<\/p>\n<p><span style=\"color: #0000ff;\"><strong>Views for right coronary angiography<\/strong><\/span><\/p>\n<p><em><strong><span style=\"color: #0000ff;\">RAO view<\/span><\/strong><\/em> shows the conus branch and sinus node artery in opposite directions as seen in the image below. Right ventricular branches and posterior descending artery (PDA) are seen well. Multiple septal branches can be seen arising from the PDA. PDA has a mild lesion in the proximal portion. In the angiogram illustrated, the posterior left ventricular branch is occluded and only a stump (PLV stump) is seen. Atrioventricular nodal artery usually originates near the bifurcation of the right coronary artery into PDA and PLV.<\/p>\n<figure style=\"width: 508px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2008\/10\/rca1.jpg\" alt=\"Right coronary angiogram in RAO view\" width=\"508\" height=\"470\"><figcaption class=\"wp-caption-text\">Right coronary angiogram in RAO view<\/figcaption><\/figure>\n<p>Here is another right coronary angiogram in RAO view. Here the septal branches of PDA and PLV branch are well seen.<\/p>\n<figure id=\"attachment_35020\" aria-describedby=\"caption-attachment-35020\" style=\"width: 1200px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-35020 size-full\" src=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2016\/11\/RCA-stenosis2-1.jpg\" sizes=\"auto, (max-width: 1200px) 100vw, 1200px\" srcset=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2016\/11\/RCA-stenosis2-1.jpg 1200w, https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2016\/11\/RCA-stenosis2-1-300x244.jpg 300w, https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2016\/11\/RCA-stenosis2-1-1024x834.jpg 1024w, https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2016\/11\/RCA-stenosis2-1-768x625.jpg 768w\" alt=\"Right coronary angiogram in RAO view\" width=\"1200\" height=\"977\"><figcaption id=\"caption-attachment-35020\" class=\"wp-caption-text\">Right coronary angiogram in RAO view<\/figcaption><\/figure>\n<p>RAO view shows the proximal part of the right coronary artery in a vertical line. RAO view is identified with the spine seen on the right side. Tight stenosis is seen just before the origin of a right ventricular branch.<\/p>\n<p><em><strong><span style=\"color: #0000ff;\">LAO view<\/span><\/strong><\/em> usually shows the full length of the right coronary artery in a C shape. Distally the right coronary artery divides into PDA and PLV at the crux cordis. Crux cordis is the junction of the atrioventricular and interventricular grooves posteriorly.&nbsp;<\/p>\n<figure id=\"attachment_37714\" aria-describedby=\"caption-attachment-37714\" style=\"width: 1200px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-37714 size-full\" src=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2009\/06\/Right-coronary-angiogram-in-LAO-view.png\" sizes=\"auto, (max-width: 1200px) 100vw, 1200px\" srcset=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2009\/06\/Right-coronary-angiogram-in-LAO-view.png 1200w, https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2009\/06\/Right-coronary-angiogram-in-LAO-view-300x269.png 300w, https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2009\/06\/Right-coronary-angiogram-in-LAO-view-1024x917.png 1024w, https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2009\/06\/Right-coronary-angiogram-in-LAO-view-768x688.png 768w\" alt=\"Right coronary angiogram in LAO view\" width=\"1200\" height=\"1075\"><figcaption id=\"caption-attachment-37714\" class=\"wp-caption-text\">Right coronary angiogram in LAO view<\/figcaption><\/figure>\n<p>The artery which crosses the crux is defined as the dominant coronary artery. Right coronary dominance is much more common than left dominance. Even when the right coronary artery is dominant, the major portion of left ventricular myocardium is supplied by the left coronary artery.<\/p>\n<p><em><strong><span style=\"color: #0000ff;\">PA cranial view<\/span><\/strong><\/em> of right coronary angiogram is shown below. As in other cranial views, diaphragmatic contour can be seen high up in the field.<\/p>\n<figure style=\"width: 451px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2009\/08\/RCA-in-PA-cranial-view1.jpg\" alt=\"Right coronary angiogram in PA cranial view\" width=\"451\" height=\"359\"><figcaption class=\"wp-caption-text\">Right coronary angiogram in PA cranial view<\/figcaption><\/figure>\n<p>A tight lesion is seen in proximal portion of PDA, marked as 1. PLV: posterior left ventricular branch; AM: acute marginal branch; RCA: right coronary artery. Conus: conus branch of the right coronary artery. Sometimes while cannulating the right coronary artery, the catheter slips into the conus artery. This causes wedging and damping of catheter tip pressure. Prolonged inadvertent injection of contrast into the conus branch can cause ventricular tachycardia or ventricular fibrillation occasionally. A large conus branch crossing the right ventricular outflow tract can cause problem during intra cardiac repair of Tetralogy of Fallot.<\/p>\n<p><em><strong><span style=\"color: #0000ff;\">LAO cranial view<\/span><\/strong><\/em> of right coronary angiogram using an Amplatz right catheter is given below.&nbsp;<\/p>\n<figure id=\"attachment_37436\" aria-describedby=\"caption-attachment-37436\" style=\"width: 1200px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-37436 size-full\" src=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2009\/09\/Right-coronary-angiogram-in-LAO-cranial-view-using-Amplatz-RCA-catheter.png\" sizes=\"auto, (max-width: 1200px) 100vw, 1200px\" srcset=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2009\/09\/Right-coronary-angiogram-in-LAO-cranial-view-using-Amplatz-RCA-catheter.png 1200w, https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2009\/09\/Right-coronary-angiogram-in-LAO-cranial-view-using-Amplatz-RCA-catheter-297x300.png 297w, https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2009\/09\/Right-coronary-angiogram-in-LAO-cranial-view-using-Amplatz-RCA-catheter-1012x1024.png 1012w, https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2009\/09\/Right-coronary-angiogram-in-LAO-cranial-view-using-Amplatz-RCA-catheter-768x777.png 768w\" alt=\"Right coronary angiogram in LAO cranial view using Amplatz RCA catheter\" width=\"1200\" height=\"1214\"><figcaption id=\"caption-attachment-37436\" class=\"wp-caption-text\">Right coronary angiogram in LAO cranial view using Amplatz RCA catheter<\/figcaption><\/figure>\n<p>This RCA was difficult to cannulate with Judkins right catheter even after repeated attempts. The angiogram shows only minimal luminal irregularities of the RCA. Right ventricular branches are seen originating from the proximal region and terminal branching of RCA into posterior left ventricular (PLV or PLB) branches and posterior descending coronary artery (PDA).<\/p>\n<p><span style=\"color: #0000ff;\"><strong>References&nbsp;<\/strong><\/span><\/p>\n<ol>\n<li>Di Mario C, Sutaria N. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/15958378\/\">Coronary angiography in the angioplasty era: projections with a meaning<\/a>. Heart. 2005 Jul;91(7):968-76.<\/li>\n<li>Aquilina O, Grech V, Felice H, Debono J, Fenech A. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/22368661\/\">Normal adult coronary angiography<\/a>. Images Paediatr Cardiol. 2006 Apr;8(2):1-16.<\/li>\n<\/ol>\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Coronary angiographic views Coronary angiography is done in multiple projections or views to get a three dimensional idea of the coronary lesions. Some regions of the coronary arteries may appear foreshortened in certain views so that true length of the lesion may not be appreciated. Actual severity of eccentric stenosis can be ascertained only by [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":45580,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[18],"tags":[],"class_list":["post-45572","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-angiography-and-interventions"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Coronary angiographic views - All About Cardiovascular System and Disorders<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/johnsonfrancis.org\/professional\/coronary-angiographic-views\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Coronary angiographic views - All About Cardiovascular System and Disorders\" \/>\n<meta property=\"og:description\" content=\"Coronary angiographic views Coronary angiography is done in multiple projections or views to get a three dimensional idea of the coronary lesions. Some regions of the coronary arteries may appear foreshortened in certain views so that true length of the lesion may not be appreciated. 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