title: Qualitative comparison of coronary angiograms between 4 French catheters with an advanced cardiovascular injection system and 6 French catheters with manual injection.
abstract: OBJECTIVE
  This study aimed to test whether advanced cardiovascular injection (ACI) via 4 French (Fr) catheters is more advantageous than manual injection with 6 Fr catheters.
  
  
  BACKGROUND
  For coronary angiography, proponents of contrast media ACI believe it utilizes smaller-diameter catheters when compared with manual injection, without compromising the quality of the angiogram, and has the potential to reduce the amount of contrast used and lessen the use of closure devices.
  
  
  METHODS
  In a prospective study, 200 consecutive patients referred for elective coronary angiography were randomized to standard 6 Fr catheters with manual injection versus 4 Fr catheters with ACI. The study's primary endpoint is the quality of the coronary angiogram. Secondary endpoints include groin complications, utilization of closure devices, and volume of contrast media. Thirty-six patients who underwent ad hoc percutaneous coronary intervention were excluded from the analysis.
  
  
  RESULTS
  The final analysis included 80 patients treated with 4 Fr catheters with ACI and 84 patients treated with 6 Fr catheters with manual injection. The groups had similar demographic and clinical characteristics. The quality of the angiogram was similar between groups with the exception of more left coronary sinus flush with 4 Fr catheters (3.57 ± 1.1 vs. 2.98 ± 0.9, P < 0.001) and less closure device use with 4 Fr (25 vs. 71.4%, P < 0.01) compared to 6 Fr catheters. The procedure duration, volume of contrast used, vascular complications, and time to ambulation were similar between groups (all P > 0.05).
  
  
  CONCLUSIONS
  4 Fr diagnostic catheters with ACI offer similar quality coronary angiograms, similar rates of vascular complications, procedure duration, contrast used, and time to ambulation, but have a significantly lesser need for closure devices compared to the 6 Fr system with manual injection.
authors.affiliation: Division of Cardiology, Washington Hospital Center, 110 Irving Street, NW, Washington, DC 20010, USA.
authors.forename: Manuel A
authors.initials: MA
authors.lastname: Gonzalez
authors.forename: Itsik
authors.initials: I
authors.lastname: Ben-Dor
authors.forename: Michael A
authors.initials: MA
authors.lastname: Gaglia
authors.forename: Rebecca
authors.initials: R
authors.lastname: Torguson
authors.forename: Hirity
authors.initials: H
authors.lastname: Shimellis
authors.forename: Anh
authors.initials: A
authors.lastname: Bui
authors.forename: William O
authors.initials: WO
authors.lastname: Suddath
authors.forename: Augusto D
authors.initials: AD
authors.lastname: Pichard
authors.forename: Lowell F
authors.initials: LF
authors.lastname: Satler
authors.forename: Ron
authors.initials: R
authors.lastname: Waksman
mesh_terms: D000328:Adult; D000368:Aged; D006328:Cardiac Catheterization / Q000295:instrumentation*; D057785:Catheters; D003287:Contrast Media / Q000008:administration & dosage*; D017023:Coronary Angiography / Q000295:instrumentation* / Q000379:methods; D003327:Coronary Disease / Q000000981:diagnostic imaging; D004867:Equipment Design; D004869:Equipment Safety; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007269:Injections, Intra-Arterial / Q000295:instrumentation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012016:Reference Values; D017751:Safety Management; D012680:Sensitivity and Specificity; D013594:Syringes; D013997:Time Factors
chemical_list: D003287:Contrast Media