Coronary angiography using 4 Fr catheters with acisted power injection: A randomized comparison to 6 Fr manual technique and early ambulation

Coronary angiography using 4 Fr catheters may reduce access site complicati ons, promote better utilization of outpatient facilities, but at a cost of suboptimal image quality. To determine whether 4 Fr diagnostic angiography with power injection (Acist, Minneapolis, MN) was equivalent to 6 Fr manual technique, 101 unselected patients were randomized to transfemoral coronar y angiography with 4 or 6 Fr catheters. Procedural characteristics, angiogr aphic quality scores, and results of 90 min ambulation were analyzed. Coron ary angiographic quality scores using 4 Fr and 6 Fr catheters were equivale nt (left coronary artery 4.73 +/- 0.6 vs. 4.80 +/- 0.65, P = 0.28; right co ronary artery 4.98 +/- 90.13 vs. 4.97 +/- 0.16, P = 0.48). However, 4 Fr le ft ventriculographic image score was lower (4.53 +/- 0.68 vs. 4.83 +/- 0.42 , P = 0.0002), attributed, in part, to a smaller injected contrast volume ( 32 +/- 11 vs. 37 +/- 4 mt, P = 0.001), The total study contrast volume was significantly less in the 4 Fr group (119 +/- 35 vs. 159 +/- 52 mt, P = 0.0 01), Complications related to early ambulation at 90 min were similar and m inimal in both groups. Compared to 6 Fr manual contrast injection technique , diagnostic angiography through 4 Fr catheters with power contrast injecti on resulted in equivalent coronary angiographic image quality, slightly red uced but diagnostic left ventricular image quality, and significantly less contrast volume, Four Fr angiography facilitates early ambulation without c ompromising safety and image quality. (C) 2001 Wiley-Liss, Inc.