冠状动脉造影及其分析.ppt

LAD（对角支、隔支、前降支）侧支至RCA、LCX第53页,共55页，2024年2月25日，星期天RCA闭塞，LAD、LCX分支至RCA末梢第54页,共55页，2024年2月25日，星期天感谢大家观看第55页,共55页，2024年2月25日，星期天**Thecoronaryarteryostiumcanvaryinplacementintheascendingaorta.Thisslideshowsthetypesofvariation.Coronaryostiallocation:high,low,anterior,posteriorCoronaryostialorientation:superior,lateral,inferior,shepherd’scrook(RCA’sonly)**Asmallercurveguidecathetermaybepreferableinahightakeoff.**Lateral:departsatahorizontalangle(90o).Inferior:departsatadownwardangle(45o-60o).Ifchoosingalongercurve,thelongerdistancebetweentheprimaryandsecondarycurveallowsthecathetertositslightlyfartheruptheaorticroot,positioningthetipmoreinferiorly.Superior:departsatanupwardangle(90o-120o).Ifchoosingashortercurve,theshorterdistancebetweentheprimaryandsecondarycurveallowsthecathetertositslightlyfartherdowntheaorticroot,positioningthetipmoresuperiorly.**TherearetwocommonanatomicvariationsassociatedwiththeRCA,aninferiortakeoffandaShepherd’sCrooktakeoff.AShepherd’sCrooktakeoffiswhenthecoronaryarterydepartstheaortaatanupwardangle,thenmakesasharploopdown.Thecoronaryisshapedlikethetopofashepherd’sstaff.ThemostdifficultofthesevariationsisaShepherd’sCrookwithaveryshortinitialorigin.**Allowparticipantstoidentifyostialtakeoffsbeforebringinglabelsontoscreen.Angiographicviewsdepictinglateral,inferiorandsuperiorleftcoronaryarterytakeoffs.Pleasenotethattheangiographicprojectionusedcouldaltertheseimages,dependingontheangleofthecamera.AlloftheseappeartobeLAOswiththespineandcatheterinthesameposition.RAOviewsdeterminethetakeoffangleoftheleftcoronarysystem.RAOviewsdeterminecoaxialengagementofthetipintheleftmaincoronaryartery.**Allowparticipantstoidentifyostialtakeoffsbefore