title: Coronary angiography using 4 French catheters with power injection: a randomized comparison with 6 French catheters.
abstract: BACKGROUND
  Coronary angiography using 4 F catheters may reduce access-site complications and enable early ambulation, although earlier studies suggested that the quality of images may be an issue of concern.
  
  
  RESULTS
  To ascertain the quality of angiographic images and safety of early ambulation, 500 patients were randomized to coronary angiography with either 4 F or 6 F catheters. Procedural characteristics, angiographic quality scores and results of ambulation were analyzed in the two groups. Patients in the 4 F group were mobilized at 2 hours post-procedure while those in the 6 F group were ambulated at 6 hours. There was no procedure-related complication in either group. The procedure was successfully completed in 250 of 252 patients randomized to the 4 F group. In two patients in the 4 F group, sheaths were upgraded to 6 F to complete the procedure, as difficulty was encountered in hooking the coronary ostium with a 4 F Judkin's catheter. Coronary angiographic quality scores in these two groups were comparable. Angiographic scores for the 4 F and 6 F groups for the left coronary artery averaged 4.45+/-0.5 and 4.58+/-0.3 (p>0.1), respectively. The right coronary artery scores averaged 4.30+/-0.4 and 4.35+/-0.2 (p>0.1) in the 4 F and 6 F groups. Angiographic scores for the left ventricular angiogram averaged 4.22+/-0.1 and 4.44+/-0.3 (p>0.1) in the 4 F and 6 F groups, respectively. None of the angiograms were assigned a score of <3.0 (not diagnostic). The total contrast volume consumed in the two groups was also equivalent. There were no groin-related complications in the 4 F group although these patients were ambulated 2 hours after the procedure.
  
  
  CONCLUSIONS
  Coronary angiography performed with a 4 F catheter is a safe and reliable procedure. The quality of image obtained with a 4 F catheter is equivalent to that obtained with a 6 F catheter. Early ambulation at 2 hours is feasible without compromising safety.
authors.affiliation: Department of Cardiology, Cardiothoracic Centre, All India Institute of Medical Sciences, New Delhi.
authors.forename: Parneesh
authors.initials: P
authors.lastname: Arora
authors.forename: Nitish
authors.initials: N
authors.lastname: Naik
authors.forename: V K
authors.initials: VK
authors.lastname: Bahl
authors.forename: S
authors.initials: S
authors.lastname: Mishra
authors.forename: R
authors.initials: R
authors.lastname: Yadav
authors.forename: S
authors.initials: S
authors.lastname: Sharma
authors.forename: S C
authors.initials: SC
authors.lastname: Manchanda
mesh_terms: D000328:Adult; D000368:Aged; D006328:Cardiac Catheterization / Q000295:instrumentation*; D017023:Coronary Angiography / Q000295:instrumentation*; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D004434:Early Ambulation; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity