title: Coronary artery injection technique: a quantitative in vivo investigation using modern catheters.
abstract: To date, there have been no quantitative in vivo assessments of contrast volumes and injection rates using modern high flow catheters during coronary angiography. Contrast volumes (n = 554), injection durations (n = 563), and injection rates (n = 498) were collected during 88 cardiac catheterizations. With increasing cathetersize (6, 7, and 8 French), injection volume increased (P < 0.0001), duration decreased (P < 0.0001), and rate increased (P < 0.0001). Compared with injections into the right coronary artery, left coronary artery injections were larger (7.1 +/- 0.1 cc vs. 4.8 +/- 0.1 cc, p < 0.0001), longer (3.6 +/- 0.05 sec vs 3.0 +/- 0.07 sec, P < 0.0001) and faster (2.1 +/- 0.04 cc/sec vs. 1.7 +/- 0.06 cc/sec, P < 0.0001). Patients with a significant stenosis in the left main or proximal right coronary artery received less contrast (P < 0.0001) more slowly (P < 0.0001) over a similar duration of injection (P = NS). When collaterals arose from the injected artery, angiographers injected more contrast (P < 0.001) over a longer period (P < 0.0001) more slowly (P < 0.0001). Catheter size and the injected vessel's location and anatomy significantly affect coronary catheterization injection technique.
authors.affiliation: Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA. JTDodge@BICS.BWH.Harvard.edu
authors.forename: J T
authors.initials: JT
authors.lastname: Dodge
authors.forename: M
authors.initials: M
authors.lastname: Nykiel
authors.forename: J
authors.initials: J
authors.lastname: Altmann
authors.forename: K
authors.initials: K
authors.lastname: Hobkirk
authors.forename: M
authors.initials: M
authors.lastname: Brennan
authors.forename: C M
authors.initials: CM
authors.lastname: Gibson
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation; D006328:Cardiac Catheterization / Q000295:instrumentation*; D002932:Cineangiography / Q000295:instrumentation*; D003287:Contrast Media / Q000008:administration & dosage*; D017023:Coronary Angiography / Q000295:instrumentation*; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000628:therapy; D004867:Equipment Design; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000628:therapy; D006801:Humans; D007269:Injections, Intra-Arterial / Q000295:instrumentation; D012008:Recurrence; D012016:Reference Values; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media