ABSTRACT
Coronary angiography is still considered as a cornerstone in the diagnosis of coronary artery disease (CAD), despite its inherent limitations. Quantitative coronary angiography (QCA) is an accurate and reproducible way to quantify the extent of coronary stenoses, as opposed to highly variable visual estimates. Conventional single-vessel analysis is inadequate for bifurcation lesions; dedicated QCA algorithms have been developed and validated instead. The validity of twodimensional (2D) angiography is limited by foreshortening, variable magnifi cation, and vessel overlap; 3D angiographic reconstruction eliminates these shortcomings providing reliable results in real time. Rotational coronary angiography can minimize contrast use, radiation exposure, and procedure time without jeopardizing its diagnostic accuracy. Angiographic measurements can be used on-line to guide coronary interventions, whereas off-line they serve as surrogate endpoints for clinical events in angiographic trials. It is expected that recent advances in coronary angiography will improve its correlation with functional indices and invasive imaging modalities; the potential to improve clinical outcome remains to be proven.
