ABSTRACT
Compared with 6F catheters, diagnostic coronary angiographic and ventriculographic images with 4F catheters can be obtained with equivalent results using less radiographic contrast volume. Whether 4F coronary angiography would be superior using a power-assisted, operator-controlled technique compared with manual technique is unknown. To determine whether 4F coronary angiography using operator-controlled power injection (Acist, Minneapolis, MN) was equivalent or superior to the 4F manual technique, 96 unselected patients undergoing transfemoral coronary angiography were randomized to 4F catheter using a power injection or manual technique. Procedural characteristics and angiographic quality scores were analyzed. Comparing the 4F manual with the 4F power-injection technique, coronary angiographic quality scores were equivalent (left coronary artery 4.7 +/- 0.5 vs. 4.7 +/- 0.6, P = 0.99; right coronary artery 4.94 +/- 0.2 vs. 4.88 +/- 0.1, P = 0.21). Left ventriculography scores were lower in 4F Acist with similar contrast volumes. The total study contrast volume was significantly less in the 4F Acist group (119 +/- 35 vs. 149 +/- 49 ml, P = 0.001). Compared with the 4F manual contrast injection technique, diagnostic angiography through 4F catheters with power contrast injection resulted in equivalent coronary angiographic image quality with significantly less radiographic contrast volume.
Subject(s)
Catheterization/statistics & numerical data , Coronary Angiography , Adult , Aged , Cardiac Catheterization/instrumentation , Cardiac Catheterization/methods , Coronary Disease/diagnostic imaging , Female , Humans , Male , Middle Aged , Pilot Projects , Prospective StudiesABSTRACT
Coronary angiography using 4 Fr catheters may reduce access site complications, promote better utilization of outpatient facilities, but at a cost of suboptimal image quality. To determine whether 4 Fr diagnostic angiography with power injection (Acist, Minneapolis, MN) was equivalent to 6 Fr manual technique, 101 unselected patients were randomized to transfemoral coronary angiography with 4 or 6 Fr catheters. Procedural characteristics, angiographic quality scores, and results of 90 min ambulation were analyzed. Coronary angiographic quality scores using 4 Fr and 6 Fr catheters were equivalent (left coronary artery 4.73 +/- 0.6 vs. 4.80 +/- 0.65, P = 0.28; right coronary artery 4.98 +/- 90.13 vs. 4.97 +/- 0.16, P = 0.48). However, 4 Fr left ventriculographic image score was lower (4.53 +/- 0.68 vs. 4.83 +/- 0.42, P = 0.0002), attributed, in part, to a smaller injected contrast volume (32 +/- 11 vs. 37 +/- 4 mL, P = 0.001). The total study contrast volume was significantly less in the 4 Fr group (119 +/- 35 vs. 159 +/- 52 mL, P = 0.001). Complications related to early ambulation at 90 min were similar and minimal in both groups. Compared to 6 Fr manual contrast injection technique, diagnostic angiography through 4 Fr catheters with power contrast injection resulted in equivalent coronary angiographic image quality, slightly reduced but diagnostic left ventricular image quality, and significantly less contrast volume. Four Fr angiography facilitates early ambulation without compromising safety and image quality.
Subject(s)
Cardiac Catheterization/instrumentation , Contrast Media/administration & dosage , Coronary Angiography/instrumentation , Coronary Disease/diagnostic imaging , Early Ambulation , Ventricular Function, Left/physiology , Adult , Aged , Coronary Disease/physiopathology , Female , Heart Ventricles/diagnostic imaging , Humans , Male , Middle Aged , Sensitivity and Specificity , Syringes , Transducers, PressureSubject(s)
Hemodynamics/physiology , Pericarditis, Constrictive/diagnosis , Respiratory Physiological Phenomena , Ventricular Pressure/physiology , Aged , Cardiac Catheterization , Echocardiography, Doppler , Humans , Male , Middle Aged , Pericarditis, Constrictive/physiopathology , Ventricular FunctionABSTRACT
Although cardiac involvement has been commonly described in HIV-infected patients, cardiac tamponade is an unusual feature of AIDS-related non-Hodgkin's lymphoma. We describe an AIDS patient with undiagnosed non-Hodgkin's lymphoma presenting with hemodynamics of pericardial tamponade.
