The RAO caudal view and one cranial view may be performed. The former allows the assessment of LM, LCx, and proximal and apical LAD; the latter allows the assessment of the mid and distal LAD and diagonal branches. Perpendicular angles are either cranial (downward view from the head of the patient) or caudal (upward view from the foot of the patient) ( Fig.
14-2 ). No fixed sequence of order in visualization is used because each patient may have different indications for coronary angiography. Spider view or LAO caudal view is often the first view taken during coronary angiography. This view is useful in visualising the left main coronary artery and its bifurcation into left anterior descending (LAD) coronary artery and left circumflex (LCX) coronary artery.
caudal view, Caudal view: The image intensifier is tilted towards the feet of the patient and the diaphragm is usually not seen in the image. It is the best view for the left anterior descending artery (LAD) and its diagonal branches [3, 6]. Generally, for circumflex and proximal epicardial visualization the caudal views are most useful. For LAD and LAD/diagonal bifurcation visualization the cranial views are most useful. In the “cranial” view, the X-ray beam originates caudally and passes through the heart to the image intensifier, which is angled cranially.
caudal view, Conversely, in a caudal projection, the X-ray tube is angled cranially and projects the X-ray beam caudally to the image tube. For LCA Cranial view: usually better for distal segments Caudal view: usually better for proximal segments It provides a detailed overview of the typical anatomy and branches of the left main, left anterior descending, left circumflex, and right coronary arteries. It also describes common anatomical variations and anomalies seen in coronary arteries and their clinical implications.
