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Impact of catheter down-sizing and power injector use on the amount of contrast medium delivered

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Abstract

The purpose of this study is to evaluate the effect of catheter down-sizing and power injector use on the amount of contrast medium delivered during diagnostic coronary angiography (CAG). We retrospectively studied 735 patients undergoing diagnostic CAG. Patients were divided into four groups according to catheter size [4 French (Fr) or 5 Fr] and the method of contrast injection (manual or power injection). Total contrast volume, procedure time, number of catheters used and angiogram quality were analyzed. Down-sizing catheters from 5 Fr to 4 Fr reduced the amount of contrast medium in both manual injection (from 153 ± 22 to 137 ± 17 ml, −10%, p < 0.0001) and power injection (from 135 ± 12 to 125 ± 16 ml, −7%, p < 0.0001). Introduction of power injection reduced the amount of contrast medium in both 4-Fr catheters (from 137 ± 17 to 125 ± 16 ml, −9%, p < 0.0001) and 5-Fr catheters (from 153 ± 22 to 135 ± 12 ml, −12%, p < 0.0001). A 28-ml (18%) reduction in contrast medium volume occurred when catheter down-sizing was combined with power injector use. Angiogram quality was not different among the four groups. Down-sizing the catheters from 5 Fr to 4 Fr and the use of a power injector reduced the amount of contrast medium delivered in CAG without reducing angiographic image quality.

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References

  1. Sones FM Jr, Shirey EK. Cine coronary arteriography. Mod Concepts Cardiovasc Dis. 1962;31:735–8.

    PubMed  Google Scholar 

  2. Davis K, Kennedy JW, Kemp HG Jr, Judkins MP, Gosselin AJ, Killip T. Complications of coronary arteriography from the Collaborative Study of Coronary Artery Surgery (CASS). Circulation. 1979;59:1105–12.

    CAS  PubMed  Google Scholar 

  3. Johnson LW, Lozner EC, Johnson S, Krone R, Pichard AD, Vetrovec GW, et al. Coronary arteriography 1984–1987: a report of the registry of the society for cardiac angiography and interventions. I. Results and complications. Cathet Cardiovasc Diagn. 1989;17:5–10.

    Article  CAS  PubMed  Google Scholar 

  4. Lefevre T, Morice MC, Bonan R, Dumas P, Louvard Y, Karrillon G, et al. Coronary angiography using 4 or 6 French diagnostic catheters: a prospective, randomized study. J Invasive Cardiol. 2001;13:674–7.

    CAS  PubMed  Google Scholar 

  5. Brown RI, MacDonald AC. Use of 5 French catheters for cardiac catheterization and coronary angiography: a critical review. Cathet Cardiovasc Diagn. 1987;13:214–7.

    Article  CAS  PubMed  Google Scholar 

  6. Metz D, Chapoutot L, Brassellet C, Jolly D. Randomized evaluation of four versus five French catheters for transfemoral coronary angiography. Clin Cardiol. 1999;22:29–32.

    Article  CAS  PubMed  Google Scholar 

  7. Khoukaz S, Kern MJ, Bitar SR, Azrak E, Eisenhauer M, Wolford T, et al. Coronary angiography using 4 Fr catheters with acisted power injection: a randomized comparison to 6 Fr manual technique and early ambulation. Catheter Cardiovasc Interv. 2001;52:393–8.

    Article  CAS  PubMed  Google Scholar 

  8. Weinrauch LA, Healy RW, Leland OS Jr, Goldstein HH, Kassissieh SD, Libertino JA, et al. Coronary angiography and acute renal failure in diabetic azotemic nephropathy. Ann Int Med. 1977;86:56–9.

    CAS  PubMed  Google Scholar 

  9. Parfrey PS, Griffiths SM, Barrett BJ, Paul MD, Genge M, Withers J, et al. Contrast material-induced renal failure in patients with diabetes mellitus, renal insufficiency, or both: a prospective controlled study. N Engl J Med. 1989;320:143–9.

    Article  CAS  PubMed  Google Scholar 

  10. Best PJ, Lennon R, Ting HH, Bell MR, Rihal CS, Holmes DR, et al. The impact of renal insufficiency on clinical outcomes in patients undergoing percutaneous interventions. J Am Coll Cardiol. 2002;39:1113–9.

    Article  PubMed  Google Scholar 

  11. McCullough PA, Wolyn R, Rocher LL, Levin RN, O’Neill WW. Acute renal failure after coronary intervention: incidence, risk factors and relationship to mortality. Am J Med. 1997;103:368–75.

    Article  CAS  PubMed  Google Scholar 

  12. Rihal CS, Textor SC, Grill DE, Berger PB, Ting HH, Best PJ, et al. Incidence and prognostic importance of acute renal failure after percutaneous coronary intervention. Circulation. 2002;105:2259–64.

    Article  PubMed  Google Scholar 

  13. Gruberg L, Mintz GS, Mehran R, Gangas G, Lansky AJ, Kent KM, et al. The prognostic implications of further renal function deterioration within 48 h of interventional coronary procedures in patients with pre-existent chronic renal insufficiency. J Am Coll Cardiol. 2000;36:1542–8.

    Article  CAS  PubMed  Google Scholar 

  14. Mangano CM, Diamondstone LS, Ramsay JG, Aggarwal A, Herskowitz A, Mangano DT. Renal dysfunction after myocardial revascularization: risk factors, adverse outcomes, and hospital resource utilization. Ann Int Med. 1998;128:194–203.

    CAS  PubMed  Google Scholar 

  15. Gruberg L, Mehran R, Dangas G, Mintz GS, Waksman R, Kent KM, et al. Acute renal failure requiring dialysis after percutaneous coronary interventions. Catheter Cardiovasc Interv. 2001;52:409–16.

    Article  CAS  PubMed  Google Scholar 

  16. Gruberg L, Dangas G, Mehran R, Mintz GS, Kent KM, Pichard AD, et al. Clinical outcome following percutaneous coronary interventions in patients with chronic renal failure. Catheter Cardiovasc Interv. 2002;55:66–72.

    Article  PubMed  Google Scholar 

  17. Iakovou I, Dangas G, Mehran R, Lansky AJ, Ashby DT, Fahy M, et al. Impact of gender on the incidence and outcome of contrast-induced nephropathy after percutaneous coronary intervention. J Invasive Cardiol. 2003;15:18–22.

    PubMed  Google Scholar 

  18. Freeman RV, O’Donnell M, Share D, Meengs WL, Kline-Rogers E, Clark VL, et al. Nephropathy requiring dialysis after percutaneous coronary intervention and the critical role of an adjusted contrast dose. Am J Cardiol. 2002;90:1068–73.

    Article  PubMed  Google Scholar 

  19. Goldstein JA, Kern M, Wilson R. A novel automated injection system for angiography. J Interv Cardiol. 2001;14:147–52.

    Article  CAS  PubMed  Google Scholar 

  20. Todd DM, Hubner PJ, Hudson N, Sarma J, McCance AJ, Caplin J. Multicentre, prospective, randomized trial of 4 vs. 6 French catheters in 410 patients undergoing coronary angiography. Catheter Cardiovasc Interv. 2001;54:269–75.

    Article  CAS  PubMed  Google Scholar 

  21. Chahoud G, Khoukaz S, El-Shafei A, Azrak E, Bitar S, Kern MJ. Randomized comparison of coronary angiography using 4F catheters: 4F manual versus “Acisted” power injection technique. Catheter Cardiovasc Interv. 2001;53:221–4.

    Article  CAS  PubMed  Google Scholar 

  22. Cigarroa RG, Lange RA, Williams RH, Hillis LD. Dosing of contrast material to prevent contrast nephropathy in patients with renal disease. Am J Med. 1989;86:649–52.

    Article  CAS  PubMed  Google Scholar 

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  1. Division of Cardiology, Department of Internal Medicine, Yokohama Sakae Kyosai Hospital, Federation of National Public Service Personnel Mutual Associations, 132 Katsura-cho, Sakae-ku, Yokohama, 247-8581, Japan

    Tsuyoshi Nozue, Ichiro Michishita & Ichiro Mizuguchi

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  1. Tsuyoshi Nozue
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  2. Ichiro Michishita
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  3. Ichiro Mizuguchi
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Correspondence to Tsuyoshi Nozue.

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Nozue, T., Michishita, I. & Mizuguchi, I. Impact of catheter down-sizing and power injector use on the amount of contrast medium delivered. Cardiovasc Interv and Ther 25, 24–28 (2010). https://doi.org/10.1007/s12928-009-0003-6

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  • DOI: https://doi.org/10.1007/s12928-009-0003-6

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