Randomized evaluation of 5 French catheters for coronary angiography with or without the CO2 powered Hercules syringe.

To evaluate the CO2 power-assisted hand-held Hercules syringe (Cordis) for diagnostic coronary angiography using 5 French catheters (Judkins number 4 exclusively), 200 consecutive patients (excluding patients with valve disease and prior bypass surgery) were randomized to conventional manual or Hercules injections. The angiography was done through a femoral artery with or without a sheath. Total duration and fluoroscopy time from the end of the ventriculogram to the end of the procedure, quantity of contrast medium required, length of cinefilm, quality of film (good, satisfactory, or bad), streaming, technical ease [scale 1 (easy) to 6 (difficult)], and need for larger catheters were analyzed. Adequate quality angiograms were obtained in 193 patients (97%). Crossover to a larger catheter was required in 7 patients due to difficulty in engaging coronary ostia (right 6, left 1). No significant differences between manual or Hercules injections were seen in total duration of the procedure (12.0 +/- 4.6 versus 12.9 +/- 8.5 min), fluoroscopy time (4.0 +/- 3.1 versus 4.2 +/- 4.8 min), quantity of contrast medium (81 +/- 28 versus 89 +/- 29 ml), and length of the film (1.1 +/- 0.6 versus 1.3 +/- 0.7 min). The conventional method was found to be easier (facility scale: conventional 1.7 +/- 0.5, Hercules 2.3 +/- 1.2, p less than 0.05) because there was significantly less dislodgement of the catheter from the coronary ostia during contrast injections. Five French number 4 Judkins catheters permit adequate diagnostic coronary angiograms in 97% of routine coronary patients.(ABSTRACT TRUNCATED AT 250 WORDS)