Cardiac Catheterization Techniques and Contrast Media Flashcards

The Judkins left 4 (JL4) catheter is designed to engage the left coronary ostium without active manipulation from which access site?

Answer: Femoral

The Judkins left 4 catheter is shaped to passively engage the left coronary ostium from the femoral approach without requiring active catheter manipulation.

During coronary angiography, the LAO cranial (Spider) view is best used to visualize which coronary segment?

Answer: Mid and distal LAD with septal perforators and diagonal branches

The LAO cranial (Spider) view elongates the mid and distal LAD, separating septal perforators and diagonal branches for optimal visualization.

What is the purpose of test injections before full contrast injection in selective coronary angiography?

Answer: To verify catheter position, exclude deep intubation or pressure damping, and confirm coaxial engagement

Small test injections confirm coaxial catheter seating, detect pressure damping from ostial disease, and ensure the catheter is not deeply intubated before a full injection.

Pressure damping during coronary catheter engagement is most commonly caused by:

Answer: Ostial coronary stenosis or catheter tip occlusion of the vessel lumen

Pressure damping indicates catheter tip occlusion of the coronary lumen, often due to ostial stenosis or a catheter that is too large for the vessel.

Fractional flow reserve (FFR) measurement requires which pharmacologic agent to induce maximal coronary hyperemia?

Answer: Adenosine

Adenosine induces maximal coronary hyperemia by causing maximal vasodilation, which is required for accurate FFR assessment of lesion physiologic significance.

During left ventriculography, the RAO 30° view is used primarily to assess:

Answer: LV anterior and inferior wall motion, chamber volume, and ejection fraction

The RAO 30° view during left ventriculography is the standard projection for assessing LV anterior and inferior wall motion, calculating chamber volumes, and ejection fraction.