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Aortic Root Catheter-Directed Coronary CT Angiography in Swine: Coronary Enhancement with Minimum Volume of Iodinated Contrast Material

Arun Kumar1, Kostaki G. Bis1, Anil Shetty1, Amit Vyas1, Andrew Anderson2, Mamtha Balasubramaniam3, William O'Neill2,4 and Wendy Stein1

1 Department of Diagnostic Radiology, William Beaumont Hospital, 3601 W 13 Mile Rd., Royal Oak, MI 48073.
2 Division of Cardiovascular Disease, William Beaumont Hospital, Royal Oak, MI.
3 Research Institute-Biostatistics, William Beaumont Hospital, Royal Oak, MI.
4 Present address: Leonard Miller School of Medicine, Miami, FL.


Figure 1
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  		Fig. 1 —5-French Medrad Vanguard diffusion catheter with 640 laser-drilled side holes (along gray pigtail end), distal tip constrictor (white end), and manually placed distal catheter bend along orange component.

 

Figure 2
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  		Fig. 2 —Pooled mean coronary attenuation with increasing concentration of Visipaque (iodixanol, GE Healthcare) using aortic root MDCTA (first four groups) and peripheral IV contrast-enhanced MDCTA (last group) with 100 mL of full-strength Visipaque. Light gray bars represent left anterior descending artery; dark gray bars, right coronary artery; and white bars, left circumflex artery.

 

Figure 3
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  		Fig. 3A —60-mm maximum intensity projections of right coronary artery obtained with aortic root MDCTA and various concentrations of Visipaque (iodixanol, GE Healthcare). Septal perforator branches of posterior descending artery (PDA) seen distally are better delineated with increasing contrast material concentration. Note faint enhancement of middle cardiac vein subjacent to PDA. A = anterior, L = left. Images obtained at concentrations of 10% (A), 20% (B), 30% (C), and 40% (D).

 

Figure 4
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  		Fig. 3B —60-mm maximum intensity projections of right coronary artery obtained with aortic root MDCTA and various concentrations of Visipaque (iodixanol, GE Healthcare). Septal perforator branches of posterior descending artery (PDA) seen distally are better delineated with increasing contrast material concentration. Note faint enhancement of middle cardiac vein subjacent to PDA. A = anterior, L = left. Images obtained at concentrations of 10% (A), 20% (B), 30% (C), and 40% (D).

 

Figure 5
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  		Fig. 3C —60-mm maximum intensity projections of right coronary artery obtained with aortic root MDCTA and various concentrations of Visipaque (iodixanol, GE Healthcare). Septal perforator branches of posterior descending artery (PDA) seen distally are better delineated with increasing contrast material concentration. Note faint enhancement of middle cardiac vein subjacent to PDA. A = anterior, L = left. Images obtained at concentrations of 10% (A), 20% (B), 30% (C), and 40% (D).

 

Figure 6
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  		Fig. 3D —60-mm maximum intensity projections of right coronary artery obtained with aortic root MDCTA and various concentrations of Visipaque (iodixanol, GE Healthcare). Septal perforator branches of posterior descending artery (PDA) seen distally are better delineated with increasing contrast material concentration. Note faint enhancement of middle cardiac vein subjacent to PDA. A = anterior, L = left. Images obtained at concentrations of 10% (A), 20% (B), 30% (C), and 40% (D).

 

Figure 7
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  		Fig. 4A —60-mm maximum intensity projections of left anterior descending and left circumflex artery obtained with aortic root MDCTA and various concentrations of Visipaque (iodixanol, GE Healthcare). Diagonal branches of left anterior descending artery (LAD) and obtuse marginal branches of left circumflex artery are better delineated with increasing contrast material concentration. Note faint enhancement of great cardiac vein subjacent to LAD. A = anterior, L = left, F = foot. Images obtained at concentrations of 10% (A), 20% (B), 30% (C), and 40% (D).

 

Figure 8
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  		Fig. 4B —60-mm maximum intensity projections of left anterior descending and left circumflex artery obtained with aortic root MDCTA and various concentrations of Visipaque (iodixanol, GE Healthcare). Diagonal branches of left anterior descending artery (LAD) and obtuse marginal branches of left circumflex artery are better delineated with increasing contrast material concentration. Note faint enhancement of great cardiac vein subjacent to LAD. A = anterior, L = left, F = foot. Images obtained at concentrations of 10% (A), 20% (B), 30% (C), and 40% (D).

 

Figure 9
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  		Fig. 4C —60-mm maximum intensity projections of left anterior descending and left circumflex artery obtained with aortic root MDCTA and various concentrations of Visipaque (iodixanol, GE Healthcare). Diagonal branches of left anterior descending artery (LAD) and obtuse marginal branches of left circumflex artery are better delineated with increasing contrast material concentration. Note faint enhancement of great cardiac vein subjacent to LAD. A = anterior, L = left, F = foot. Images obtained at concentrations of 10% (A), 20% (B), 30% (C), and 40% (D).

 

Figure 10
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  		Fig. 4D —60-mm maximum intensity projections of left anterior descending and left circumflex artery obtained with aortic root MDCTA and various concentrations of Visipaque (iodixanol, GE Healthcare). Diagonal branches of left anterior descending artery (LAD) and obtuse marginal branches of left circumflex artery are better delineated with increasing contrast material concentration. Note faint enhancement of great cardiac vein subjacent to LAD. A = anterior, L = left, F = foot. Images obtained at concentrations of 10% (A), 20% (B), 30% (C), and 40% (D).

 

Figure 11
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  		Fig. 5A —5-mm maximum intensity projections obtained with peripheral IV MDCTA after injection of 100 mL of full-strength Visipaque (iodixanol, GE Healthcare). A = anterior, L = left, F = foot. Images obtained in right coronary artery (A), left anterior descending artery (B), left circumflex artery (C), and diagonal branches (limited visualization) off left anterior descending artery (D).

 

Figure 12
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  		Fig. 5B —5-mm maximum intensity projections obtained with peripheral IV MDCTA after injection of 100 mL of full-strength Visipaque (iodixanol, GE Healthcare). A = anterior, L = left, F = foot. Images obtained in right coronary artery (A), left anterior descending artery (B), left circumflex artery (C), and diagonal branches (limited visualization) off left anterior descending artery (D).

 

Figure 13
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  		Fig. 5C —5-mm maximum intensity projections obtained with peripheral IV MDCTA after injection of 100 mL of full-strength Visipaque (iodixanol, GE Healthcare). A = anterior, L = left, F = foot. Images obtained in right coronary artery (A), left anterior descending artery (B), left circumflex artery (C), and diagonal branches (limited visualization) off left anterior descending artery (D).

 

Figure 14
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  		Fig. 5D —5-mm maximum intensity projections obtained with peripheral IV MDCTA after injection of 100 mL of full-strength Visipaque (iodixanol, GE Healthcare). A = anterior, L = left, F = foot. Images obtained in right coronary artery (A), left anterior descending artery (B), left circumflex artery (C), and diagonal branches (limited visualization) off left anterior descending artery (D).

 

Figure 15
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  		Fig. 6 —Three-dimensional whole-volume maximum intensity projection of coronary arteries obtained with aortic root contrast-enhanced MDCTA using 40% Visipaque (iodixanol, GE Healthcare) injection. No blood pool contrast interference is seen.

 

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