Traditional versus automated injection contrast system in diagnostic and percutaneous coronary interventional procedures: comparison of the contrast volume delivered.

Contrast injection with a manual stopcock-manifold system is the standard technique during diagnostic coronary angiography or percutaneous coronary intervention (PCI). The ACIST Injection System is a new automatic injection device that allows online hemodynamic monitoring, as well as control of injection rate and amount of contrast to be delivered. The aim of the study was to compare the amount of contrast media delivered using the two methods, i.e., the traditional (manual injection plus standard power injection for the left ventriculography using the ANGIOMAT-6000) versus the ACIST System programmed injector. A total of 453 consecutive patients underwent diagnostic cardiac catheterization and/or PCI at our institution. Patients were randomly assigned to either automated contrast injection with the ACIST device (n = 253) or to conventional contrast injection using a stopcock-manifold system and contrast injection by hand syringe (n = 200). In the diagnostic catheterization group, the mean quantity of contrast volume was significantly lower in the ACIST group compared to the control group (130 +/- 60 ml versus 257 +/- 64 ml, respectively; 97.4% more contrast media; p < 0.001). When the data were analyzed for patients who underwent diagnostic catheterization plus PCI, the mean quantity of contrast volume was 228 +/- 90 ml versus 350 +/- 94 ml, respectively (53.8% more contrast media; p < 0.001). For patients who underwent PCI alone, the mean quantity of contrast volume was 175 +/- 76 ml versus 275 +/- 100 ml, respectively (57.3% more contrast media; p = 0.009). When only the total volume of contrast media delivered to the patient was considered (not including the contrast wasted outside), the results were very similar.There was a significant reduction in the total volume of contrast media used (amount injected to the patient as well as the amount wasted) and in the net amount of contrast delivered to the patient with the ACIST power device when compared to the traditional method of manual contrast injection.