Complication rate of power coronary angiography injection

From 1970 to 1975, 1,498 patients underwent coronary angiography at Wilford Hall USAF Medical Center via the same injection technique utilizing a Viamonte Hobbs automatic volume injector. Most institutions now perform coronary angiography by hand injections of contrast medium, and automatic power injection angiography is reserved for ventriculograms. The Sones technique was used in 822 patients (55%) and the Judkins technique in 676 (45%). Saphenous vein grafts were studied in 12% or 180 cases. The amounts of contrast medium usually used were 4 cc for right coronary artery injection and 6 cc for left coronary artery and saphenous vein graft injections over 2 seconds. No acute coronary artery dissections, one coronary occlusion (0.067%), one death (0.067%) in a patient with greater than 90% left main coronary obstruction, and three (0.20%) acute myocardial infarctions occurred. We conclude that power injection is a safe technique for coronary angiography. This technique is easier to use, could improve the quality of coronary angiography, and may actually be safer than hand contrast medium injection.