Association between the Angle of the Left Subclavian Artery and Procedural Time for Percutaneous Coronary Intervention in Patients with Acute Coronary Syndrome

Figures

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  Figure 1. Study flow diagram. CABG, coronary artery bypass grafting; PCI, percutaneous coronary intervention.

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  Figure 2. Representative schematic images (upper panels) and CT images in the coronal view (lower panels) in patients with mild tortuosity (a) and severe tortuosity (b). (a) In a case of mild tortuosity, the angle of the left subclavian artery is 79 degrees. In this case, the time from sheath insertion to the first balloon time was 20 minutes and total procedure time was 46 minutes, respectively. (b) In patients with severe tortuosity, the angle of the left subclavian artery was 55 degrees. In this case, the time from sheath insertion to the first balloon time, the total procedure time, and the fluoroscopy time were longer than in case (a) (43 minutes and 97 minutes, respectively). (c) The angle of the aortic root on the coronal view. The details of the measurement method are shown in the text. LRA, left radial approach; PCI, percutaneous coronary intervention.

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  Figure 3. Distribution of the angle of the subclavian artery in the coronal view. The median value was 70 (57, 77) degrees, and the mean value was 68 ± 14 degree.

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  Figure 4. Correlations between the angle of the left subclavian artery in the coronal view and sheath insertion to the first balloon time (a) and total procedural time. (b) The details are shown in the text.

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  Figure 5. Incidence of contrast-induced nephropathy. Contrast-induced nephropathy occurred more frequently with an angle of the subclavian artery in the coronal view of <70 degrees than of ≥70 degrees (11 patients; 29.0% vs. 2 patients; 4.9%, P=0.005).