Nonselective angiography of the internal mammary artery: a fast, reliable, and safe technique

Selective cannulation of the mammary artery can be time consuming and carries a risk of arterial injury. The nonselective technique described here is faster, safer, and as reliable as the standard selective technique. A consecutive series of patients with previous coronary artery bypass graft surgery (CABG) were randomized to undergo either selective or nonselective mammary artery angiography. Selective angiography was performed using the standard selective technique. Nonselective angiography was performed by placing a standard catheter in the subclavian artery and hand injecting 10 ml of contrast while inflating a blood pressure cuff 10 mm above the systolic pressure in the ipsilateral arm. Fifty-six patients were studied, 30 patients selectively, and 26 patients nonselectively. The time to visualize adequately both native and grafted mammary arteries in the selective group was 4.83 + 5.00 min and in the nonselective group 1.76 + 1.16 minutes (P = 0.006). A nonselective technique for visualizing the mammary artery is significantly faster and as reliable as the standard selective technique.