Lừa dối angiographic views: Có nhiều quan điểm angiographic giảm thiểu mức độ nghiêm trọng của một phân khúc angulated hoặc mức độ nghiêm trọng của tổn thương. Tình hình phổ biến nhất là xem đuôi RAO cho một tổn thương trong LCX | 48 Practical Handbook of Advanced Interventional Cardiology CAVEAT Deceiving angiographic views There are angiographic views that minimize the severity of an angulated segment or the severity of a lesion. The most common situation is the RAO caudal view for a lesion in the LCX. This view foreshortens the proximal segment of the LCX so the ostial lesion of the LCX can be missed and the lesions in the proximal segment can be overlooked. In the RAO cranial or LAO cranial views the lesion in the distal LM can also be missed if there is a problem advancing the device or thrombus formation after manipulation of interventional hardware then the severity of the lesion is much more appreciated. In the LAO cranial view the lesion in the proximal LAD can be missed because it is foreshortened and a lesion there can be seen better in the RAO cranial view or AP cranial view. During PCI of an RCA lesion the guide is thought to be coaxial in the LAO view however after failing to advance the interventional devices or difficulty in withdrawing them it is found that the guide is not coaxial in the RAO view Table 3-7 . CAVEAT Missing lesions Coronary angiography or luminography is well known to miss severe lesions especially the short napkin ring lesion or short aorto-ostial lesions. The reason is that when the lesion is viewed from an angled projection the lesion is not seen because the adjacent contrast-filled vessel segments are projected over the short and diseased segment and mask it. In the case of an ostial lesion the tip of a small catheter can be engaged too deeply without causing ventricularization of blood pressure and spill-over of contrast in the aorto-ostial area would mask a short severe ostial lesion. This is the same problem of PCI in ostial lesion where it is difficult to position the proximal end of the stent because an angiogram will spill contrast over the ostial area Figure 3-10 . Table 3-7 Suboptimal and deceiving angiographic views 1. RAO caudal views for the .
