Ateneo - UPO

Angiography Suite: equipment, area classification, and the responsibilities of the Radiographer, Best Practices in Radiation Protection, Coronary Interventional Procedures, Structural Heart Interventional Procedures, Morphological and Functional Assessment of Coronary Stenosis Severity

Title: Apparecchiature e radiologia interventistica
Authors: R. Gerasia, L. Manzo, L. Federico, L. Canulli, S. Svetlic, F. Di Basilio
978-88-299-3577-2
Editor: Piccin-Nuova Libraria

Describe the organization of the angiography suite, the main equipment used, the classification of controlled areas, and the role of the Radiographer in interventional cardiology procedures.
Apply the principles and best practices of radiation protection to ensure patient and staff safety in compliance with current regulations.
Describe the main coronary interventional techniques, including their clinical indications, procedural workflow, relevant anatomy, radiographic projections, and the devices and materials used.
Describe the main structural heart interventions (Transcatheter Aortic Valve Implantation [TAVI], MitraClip, and Left Atrial Appendage Closure [LAAC]), including their clinical indications, technical aspects, procedural workflow, relevant anatomy, radiographic projections, and the devices and materials used.
Understand the principles and clinical applications of morphological and functional techniques for assessing the severity of coronary artery stenosis and their role in clinical decision-making, with particular emphasis on Quantitative Coronary Angiography (QCA), Fractional Flow Reserve (FFR), Instantaneous Wave-Free Ratio (iFR), Intravascular Ultrasound (IVUS), and Optical Coherence Tomography (OCT).

Students are expected to have a basic knowledge of cardiovascular anatomy and physiology, radiation physics, radiation protection, medical imaging techniques, and patient care principles.

Lectures

none

Oral examination

1. Angiography Suite: equipment used, area classification, and the role and responsibilities of the Radiographer.
2. Radiation Protection Best Practices in the Angiography Suite.
3. Diagnostic Coronary Angiography: clinical indications, procedural steps, coronary anatomy, angiographic projections, and devices/materials used, including practical training.
4. Percutaneous Coronary Intervention (PCI): clinical indications, procedural steps, and devices/materials used, including practical training.
5. Acute Myocardial Infarction: clinical rationale, procedural workflow, and devices/materials used, including practical training.
6. Hemodynamic Support Systems: intra-aortic balloon pump (IABP), Impella, and extracorporeal membrane oxygenation (ECMO).
7. Functional Techniques for the Assessment of Coronary Stenosis Severity: Quantitative Coronary Angiography (QCA), Fractional Flow Reserve (FFR), and Instantaneous Wave-Free Ratio (iFR): rationale, differences, and procedural steps.
8. Morphological Techniques for the Assessment of Coronary Stenosis Severity: with particular focus on Intravascular Ultrasound (IVUS) and Optical Coherence Tomography (OCT): rationale, differences, and procedural steps.
9. Percutaneous Left Atrial Appendage Closure: clinical indications, anatomy, procedural steps, angiographic projections, and devices/materials used.
10. Transcatheter Aortic Valve Implantation (TAVI): clinical indications, anatomy, procedural steps, angiographic projections, and devices/materials used.
11. Transcatheter Edge-to-Edge Repair (TEER) with MitraClip: clinical indications, anatomy, procedural steps, angiographic projections, and devices/materials used.

Upon successful completion of the course, students will be able to:
- organize and describe the workflow of an angiography suite;
- identify the equipment, devices, and materials used in the main interventional cardiology procedures;
- apply radiation protection principles in clinical practice;
- recognize the different stages of coronary and structural heart interventional procedures;
- identify the most appropriate radiographic projections for each procedure;
- distinguish the main techniques used to assess the severity of coronary artery stenosis (QCA, FFR, iFR, IVUS, and OCT), describe their procedural steps, and understand their clinical indications.