Impact of catheter down-sizing and power injector use on the amount of contrast medium delivered

The purpose of this study is to evaluate the effect of catheter down-sizing and power injector use on the amount of contrast medium delivered during diagnostic coronary angiography (CAG). We retrospectively studied 735 patients undergoing diagnostic CAG. Patients were divided into four groups according to catheter size [4 French (Fr) or 5 Fr] and the method of contrast injection (manual or power injection). Total contrast volume, procedure time, number of catheters used and angiogram quality were analyzed. Down-sizing catheters from 5 Fr to 4 Fr reduced the amount of contrast medium in both manual injection (from 153 ± 22 to 137 ± 17 ml, −10%, p < 0.0001) and power injection (from 135 ± 12 to 125 ± 16 ml, −7%, p < 0.0001). Introduction of power injection reduced the amount of contrast medium in both 4-Fr catheters (from 137 ± 17 to 125 ± 16 ml, −9%, p < 0.0001) and 5-Fr catheters (from 153 ± 22 to 135 ± 12 ml, −12%, p < 0.0001). A 28-ml (18%) reduction in contrast medium volume occurred when catheter down-sizing was combined with power injector use. Angiogram quality was not different among the four groups. Down-sizing the catheters from 5 Fr to 4 Fr and the use of a power injector reduced the amount of contrast medium delivered in CAG without reducing angiographic image quality.