The application of digital coronary arteriography in the evaluation of patients with known or suspected coronary artery disease is considered. Digital imaging of coronary arteries and bypass grafts can augment 35-mm cineangiography and may eventually replace film for coronary arteriography. The clinical efficacy of both selective and nonselective digital coronary arteriography is not yet established, however, a number of advantages over 35 mm cine have now been delineated including high contrast sensitivity image subtraction and digital image processing. One particular advantage of digital coronary arteriography is the ability to perform an immediate quantitative analysis of coronary images providing a reliable and consistent measure of the significance of a stenotic lesion. Technical requirements for digital coronary arteriography include a high output X-ray generator, low noise television chain, a 512 X 512 digital image matrix, frame rates of at least 15 fps, and high data storage capacity of c500 megabytes. The utilization of digital coronary imaging as a supplement or in place of 35-mm cine angiography will provide improved coronary imaging and enable quantification for more accurate and clinically significant coronary artery imaging.

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