Coronary angiography with a novel mobile radiographic imaging system

Background: Determination of coronary anatomy and flow presently requires fixed catheterization laboratory facilities. The goal of this study was to determine whether a novel mobile imaging system, potentially applicable to bedside angiography, could provide coronary angiograms of sufficient quality on which to base clinical decisions. Methods: We compared images obtained with a custom-modified mobile fluoroscope equipped with a videodisc recorder to those from standard fixed catheterization imaging equipment in 17 patients undergoing elective coronary arteriography, including four patients undergoing elective coronary angioplasty. Results: Angiography with the mobile system was safe, easy to perform, provided a full range of views, and required no larger volume of contrast dye or modification of injection technique compared with the fixed system. In every case, the mobile imaging system provided high-quality coronary angiograms with excellent resolution of the epicardial arteries and their branches. The mobile images detected all hemodynamically significant stenoses with resolution easily sufficient to judge lesion morphology and coronary flow patterns, as well as collateral flow. Furthermore, the mobile system provided image quality capable of assessing the effects of angioplasty. Conclusions: The novel mobile imaging system is capable of providing high-quality coronary images. This advance may permit coronary angiography outside a fixed catheterization laboratory, for example, in critically ill patients in a coronary care unit.