Coronary artery injection technique: A quantitative in vivo investigation using modern catheters

Abstract

To date, there have been no quantitative in vivo assessments of contrast volumes and injection rates using modern high flow catheters during coronary angiography. Contrast volumes (n ‫؍‬ 554), injection durations (n ‫؍‬ 563), and injection rates (n ‫؍‬ 498) were collected during 88 cardiac catheterizations. With increasing cathetersize (6, 7, and 8 French), injection volume increased (P F 0.0001), duration decreased (P F 0.0001), and rate increased (P F 0.0001). Compared with injections into the right coronary artery, left coronary artery injections were larger (7.1 ؎ 0.1 cc vs. 4.8 ؎ 0.1 cc, p F 0.0001), longer (3.6 ؎ 0.05 sec vs 3.0 ؎ 0.07 sec, P F 0.0001) and faster (2.1 ؎ 0.04 cc/sec vs. 1.7 ؎ 0.06 cc/sec, P F 0.0001). Patients with a significant stenosis in the left main or proximal right coronary artery received less contrast (P F 0.0001) more slowly (P F 0.0001) over a similar duration of injection (P ‫؍‬ NS). When collaterals arose from the injected artery, angiographers injected more contrast (P F 0.001) over a longer period (P F 0.0001) more slowly (P F 0.0001). Catheter size and the injected vessel's location and anatomy significantly affect coronary catheterization injection technique. Cathet. Cardiovasc.

Percutaneous Coronary Intervention Complications and Guide Catheter Size

“…This study represents the largest investigation that relates larger guide catheter size directly to contrast agent use and complications associated with PCI. Previous investigators (24,25) have related catheter size directly to volume of contrast medium used during diagnostic angiography, but did not evaluate outcome variables. Using measurement of injection pressure, volume, and time, Dodge et al (25) determined that as catheter sizes increase, injection volume and rate increased as injection duration decreased.…”