Zusammenfassung
Erste Erfahrungen in der Darstellung der Koronararterien unter In-vivo-Bedingungen wurden anhand supraaortaler Kontrastmittelinjektionen Anfang der 50er Jahre gewonnen. Technische Fortschritte der Röntgentechnik, vor allem die Einführung des Röntgenbildverstärkers und der Cineangiographie, ermöglichten später die kontrollierte Kontrastmittelinjektion unter ständiger visueller Kontrolle und waren eine wichtige Voraussetzung zur Etablierung der Koronarangiographie. Die selektive Darstellung der Herzkranzgefäße gelang erstmals Mason Sones 1959 mittels eines Mehrzweckkatheters vom Arm aus und verdrängte schnell die nichtselektiven Darstellungstechniken. Judkins und Amplatz führten 1967 unabhängig voneinander speziell vorgeformte Kathetertypen zur selektiven Intubation der Koronargefäße via transfemoralem Zugang ein. Vor allem die Judkins-Technik bestach durch ihre Einfachheit und hohe Erfolgsquote und hat dazu geführt, daß inzwischen über 80% aller diagnostischen Koronarangiographien mittels dieser Methode erfolgen. Die fortschreitende Miniaturisierung der Kathetertechnik sowie die heute an Bedeutung zunehmende ambulante Koronarangiographie haben zu einer Renaissance der Zugangstechniken vom Arm, vor allem von der A. radialis aus, geführt. Die Ende der 60er Jahre rasch an Bedeutung zunehmende aortokoronare Bypass-Chirurgie in der Therapie der koronaren Herzkrankheit hatte eine schnelle Etablierung der Koronarangiographie zur exakten Darstellung der Koronargefäße zur Voraussetzung. Die Einführung der perkutanen transluminalen koronaren Angioplastie (PTCA) durch Grüntzig als alternative, nichtoperative Revaskularisierungsmethode der Koronargefäße bedingte einen zweiten kräftigen Wachstumsschub der diagnostischen Koronarangiographie.
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Abbreviations
- LCA:
-
Linke Koronararterie
- RIVA:
-
Ramus interventricularis anterior
- RCX:
-
Ramus circumflexus
- RCA:
-
Rechte Koronararterie
- RIVP:
-
Ramus interventricularis posterior
- LIMA:
-
Linke A. mammaria interna
- RIMA:
-
Rechte A. mammaria interna
- RAO:
-
„right anterior oblique“
- LAO:
-
„left anterior oblique“
- AP:
-
„anterior — posterior“
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Windecker, S., Maier, W., Hess, O.M. (2000). Koronarangiographie. In: Hess, O.M., Simon, R.W.R. (eds) Herzkatheter. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-56967-8_3
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