Coronary artery injection technique: a quantitative in vivo investigation using modern catheters.
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.
Dodge
J T
JT
Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA. JTDodge@BICS.BWH.Harvard.edu
Nykiel
M
M
Altmann
J
J
Hobkirk
K
K
Brennan
M
M
Gibson
C M
CM
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
D003287:Contrast Media