[Effect of 5F TigerⅠcatheter shaping technique in complex coronary angiography]

Objective: To observe the effect of 5 F Tiger Ⅰ catheter shaping technique in complex coronary angiography. Methods: This study was a single-center, single-blind, randomized, parallel controlled trial and subjects were consecutively enrolled if the first coronary angiography could not be completed by 5 F Tiger Ⅰ catheterization at our department from January 2016 to June 2017 (n=159). The subjects were divided into 2 groups using a random number table method: 79 patients in the control group, and 6 F Judkins and Amplatz catheters were used to perform coronary angiography through the radial artery; 80 patients in the experimental group, and 5 F Tiger Ⅰ shaping technique were used to perform coronary angiography through the radial artery. The reasons of complex coronary angiography were divided into 3 categories: class A referred the abnormal origin of left and right coronary arteries;class B referred left or right coronary artery opening higher or lower than conventional openings or opening downwards and upwards; class C referred the ascending aorta abnormalities (longer, wider, or shorter and thinner). Coronary angiography and operative complications were compared between the 2 groups. Results: X-ray exposure time of coronary angiography ((4.17±1.67) min vs. (4.78±1.51) min, P=0.017), X-ray dose (230 (175, 275) mGy vs. 267 (230, 321) mGy, P<0.001), contrast agent dose ((54.6±8.2) ml vs. (61.8±7.9) ml, P=0.001), operative time (21.6 (18.9, 25.4) min vs. 26.8 (23.4, 31.4) min, P<0.001), and number of catheters used (1.30±0.56 vs. 2.47±0.57, P=0.001) were all less in experimental group than in the control group. There was no significant difference in success rate of the coronary angiography between the experimental group and the control group(97.5% (78/80) vs. 98.7% (78/79), P=0.567). There was no significant difference in the incidence of radial artery spasm (2.5% (2/80) vs. 5.1% (4/79), P=0.396) and coronary artery spasm (1.3% (1/80) vs. 3.8% (3/79), P=0.639). In class A and C subjects, X-ray exposure time, X-ray dose, and operation time were similar between the experimental and control groups (all P>0.05), while the number of catheters used was less in the experimental group than in the control group (P<0.01). In the class C subjects, dose of contrast agent used was significantly lower in the experimental group than in the control group (P=0.001). In theclass B subjects, the X-ray dose, contrast agent dose, operation time, and number of catheters used were all less in the experimental group than in the control group (all P<0.01), and there was no significant difference in X-ray exposure time between the 2 groups (P=0.192). Conclusion: For complex coronary angiography, the imaging success rate and safety of the 5 F Tiger Ⅰshaping catheter is comparable to that of 6 F Judkins and Amplatz catheters.