Impact of contrast agent viscosity on coronary balloon deflation times: bench testing results.
OBJECTIVE
To assess the impact of viscosity on angioplasty balloon deflation times.


BACKGROUND
Lower contrast viscosity could result in more rapid coronary balloon deflation times.


METHODS
We performed a bench comparison of coronary balloon deflation times using 2 contrast agents with different viscosity (ioxaglate and iodixanol), 3 contrast dilutions, and 2 inflation syringe filling volumes. Ten identical pairs of coronary angioplasty balloons were used to conduct each comparison after balloon inflation to 12 atmospheres. Simultaneous deflations were performed under cineangiography. The time to full contrast extraction and the area of contrast remaining after 5 seconds of deflation (quantified by opaque pixel count) were compared between groups.


RESULTS
The mean time to full contrast extraction during balloon deflation was 8.3 ± 2.5 seconds for ioxaglate (lower viscosity) versus 10.1 ± 2.9 seconds for iodixanol (higher viscosity) (17.4% decrease, P = 0.005), with a 35.6% (P = 0.004) reduction in contrast area at 5 seconds. Compared to 1:1 ioxaglate-saline mixture, 1:2 and 1:3 ioxaglate/saline mixes resulted in 26.7% (P < 0.001) and 39.0% (P < 0.001) reduction in mean balloon deflation time, respectively, but at the expense of decreased balloon opacity. Filling the inflation syringe with 5 versus 15 ml of contrast/saline solution was associated with 7.5% decrease in balloon deflation time (P = 0.005), but no difference in contrast area at 5 seconds (P = 0.749).


CONCLUSIONS
Use of a lower viscosity contrast agent and higher contrast dilution significantly reduced coronary balloon deflation times, whereas use of lower syringe filling volume had a modest effect. Rapid coronary balloon deflation could improve the safety of interventional procedures.
VA North Texas Healthcare System and University of Texas Southwestern Medical Center, Dallas, Texas.
Owen
O
Mogabgab
Vishal G
VG
Patel
Tesfaldet T
TT
Michael
Anna
A
Kotsia
George
G
Christopoulos
Subhash
S
Banerjee
Emmanouil S
ES
Brilakis
D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D002932:Cineangiography; D003287:Contrast Media; D007485:Ioxaglic Acid; D013997:Time Factors; D014283:Triiodobenzoic Acids; D014783:Viscosity
D003287:Contrast Media; D014283:Triiodobenzoic Acids; C044834:iodixanol; D007485:Ioxaglic Acid