Randomized comparison of coronary angiography using 4F catheters: 4F manual versus "acisted" power injection technique

Compared with 6F catheters, diagnostic coronary angiographic and ventriculo graphic images with 4F catheters can be obtained with equivalent results us ing less radiographic contrast volume. Whether 4F coronary angiography woul d be superior using a power-assisted, operator-controlled technique compare d with manual technique is unknown. To determine whether 4F coronary angiog raphy using operator-controlled power injection (Acist, Minneapolis, MN) wa s equivalent or superior to the 4F manual technique, 96 unselected patients undergoing transfemoral coronary angiography were randomized to 4F cathete r using a power injection or manual technique. Procedural characteristics a nd angiographic quality scores were analyzed. Comparing the 4F manual with the 4F power-injection technique, coronary angiographic quality scores were equivalent (left coronary artery 4.7 +/- 0.5 vs. 4.7 +/- 0.6, P = 0.99; ri ght coronary artery 4.94 +/- 0.2 vs. 4.88 +/- 0.1, P = 0.21). Left ventricu lography scores were lower in 4F Acist with similar contrast volumes. The t otal study contrast volume was significantly less in the 4F Acist group (11 9 +/- 35 vs. 149 +/- 49 ml, P = 0.001). Compared with the 4F manual contras t injection technique, diagnostic angiography through 4F catheters with pow er contrast injection resulted in equivalent coronary angiographic image qu ality with significantly less radiographic contrast volume. (C) 2001 Wiley- Liss, Inc.