Randomized comparison of coronary angiography using 4F catheters: 4F manual versus "Acisted" power injection...

Compared with 6F catheters, diagnostic coronary angiographic and ventriculographic images with 4F catheters can be obtained with equivalent results using less radiographic contrast volume. Whether 4F coronary angiography would be superior using a power-assisted, operator-controlled technique compared with manual technique is unknown. To determine whether 4F coronary angiography using operator-controlled power injection (Acist, Minneapolis, MN) was equivalent or superior to the 4F manual technique, 96 unselected patients undergoing transfemoral coronary angiography were randomized to 4F catheter using a power injection or manual technique. Procedural characteristics and 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; right coronary artery 4.94 +/- 0.2 vs. 4.88 +/- 0.1, P = 0.21). Left ventriculography scores were lower in 4F Acist with similar contrast volumes. The total study contrast volume was significantly less in the 4F Acist group (119 +/- 35 vs. 149 +/- 49 ml, P = 0.001). Compared with the 4F manual contrast injection technique, diagnostic angiography through 4F catheters with power contrast injection resulted in equivalent coronary angiographic image quality with significantly less radiographic contrast volume.