Which sequence best describes the typical steps of diagnostic coronary angiography?

Which sequence best describes the typical steps of diagnostic coronary angiography?

• A. Noninvasive imaging only
• B. Surgical coronary bypass planning first
• C. Only post-procedure evaluation
• D. Vascular access, anticoagulation, selective engagement of coronary ostia, aortic root and selective contrast injections, multiple views, assessment of stenoses, hemodynamic measurements as needed

Answer: (D)

The important sequence in diagnostic coronary angiography starts with gaining vascular access and giving anticoagulation to prevent clotting during the procedure. From there, the operator selectively engages the coronary ostia so contrast can be delivered precisely into each coronary artery rather than just the aorta. Then aortic root injections and selective coronary injections with contrast are performed to visualize the arteries, and images are captured from multiple views to see the arteries in three dimensions and accurately define any narrowing. After visualizing the vessels, the degree of stenosis is assessed, and hemodynamic measurements are taken as needed to determine the functional significance of lesions, such as pressure tracings across a stenosis or other physiologic data. This combination reflects the actual workflow: access, anticoagulation, selective engagement, targeted contrast injections with multiple angles, assessment of blockages, and any necessary physiological measurements. The other options skip essential steps or describe noninvasive or nonprocedural activities, which is why they don’t fit.

The important sequence in diagnostic coronary angiography starts with gaining vascular access and giving anticoagulation to prevent clotting during the procedure. From there, the operator selectively engages the coronary ostia so contrast can be delivered precisely into each coronary artery rather than just the aorta. Then aortic root injections and selective coronary injections with contrast are performed to visualize the arteries, and images are captured from multiple views to see the arteries in three dimensions and accurately define any narrowing. After visualizing the vessels, the degree of stenosis is assessed, and hemodynamic measurements are taken as needed to determine the functional significance of lesions, such as pressure tracings across a stenosis or other physiologic data.

This combination reflects the actual workflow: access, anticoagulation, selective engagement, targeted contrast injections with multiple angles, assessment of blockages, and any necessary physiological measurements. The other options skip essential steps or describe noninvasive or nonprocedural activities, which is why they don’t fit.