Coronary angiography right coronary artery
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
How to Engage the Right Coronary Artery
The Right coronary artery (RCA) is engaged in the left anterior oblique (LAO) position.
Optimal Views of the Right Coronary Artery
The following sequence of views is obtained as the gantry is swung from the 30o position to the AP cranial position with cranial angulation to the RAO 30 position.
Proximal RCA
The proximal RCA including the ostium is best visualized in the LAO 30 view with no cranial or caudal angulation.
Bifurcation of the RCA
The bifurcation of the distal RCA where the right posterolateral artery and the posterior descending artery originate is best visualized using 30 degrees of cranial angulation and no right or left angulation (the anteroposterior (AP) 0 cranial 30 view).
Mid RCA
The middle RCA is best visualized in the straight right anterior oblique (RAO) 30 view.
Right Coronary Artery
The right coronary artery appears like a letter C in the LAO projection and appears like a letter L while in the RAO projection. To expose the ostial and proximal part of the RCA, an LAO projection with caudal angulation is deployed. The distal segment of the RCA and the bifurcation into the posterior descending artery (PDA) may be exposed in an LAO cranial view coupled with deep inspiration. An AP projection with cranial angulation is required to completely expose the right posterolateral (RPL) branches of RCA.
RCA LAO View
Initial angiographic imaging of the RCA in the LAO 30 projection gives the best view of significant ostial and proximal RCA disease.
RCA RAO View
The mid RCA is best visualized in the straight RAO 30 position.
RCA AP 0 Cranial 30 View
The bifurcation of the distal RCA and rPDA is best seen in the AP 0 Cranial 30 view with a small breath in.