Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2020 Jun 8;15(6):e0234311.
doi: 10.1371/journal.pone.0234311. eCollection 2020.

More holes, more contrast? Comparing an 18-gauge non-fenestrated catheter with a 22-gauge fenestrated catheter for cardiac CT

Andreas Marco Fischer  1   2 , Philipp Riffel  1 , Thomas Henzler  1   3 , U Joseph Schoepf  2 , Andres F Abadia  1 , Richard Robert Bayer  2 , Holger Haubenreisser  1 , Dante Giovagnoli  2 , Alexander Kremer  1 , Stefan O Schoenberg  1 , Joshua Gawlitza  4
Affiliations
Comparative Study

More holes, more contrast? Comparing an 18-gauge non-fenestrated catheter with a 22-gauge fenestrated catheter for cardiac CT

Andreas Marco Fischer et al. PLoS One. .

Abstract

Objective: To compare the performance of an 18-gauge nonfenestrated catheter (18-NFC) with a 22-gauge fenestrated catheter (22-FC) for cardiac CT angiography (CCTA) in patients with suspected coronary heart disease.

Subjects and methods: 74 consecutive patients imaged on a 2nd generation dual-source CT with arterial phase CCTA were included in this retrospective investigation to either an 18-NFC or 22-FC. In comparison to the 18-NFC, the 22-FC has three additional perforations for contrast agent dispersal proximal to the tip. We examined the two groups for differences in their average attenuation in the right and left ventricles (RV, LV) and in the atrium (RA, LA) as well as in the proximal right coronary artery (RCA) and the left main coronary artery (LM). The averages were calculated for both the 18-NFC and 22-FC.

Results: Catheters were successfully placed on the first attempt 97% (36/37) for 18-NFC and 95% (35/37) for the 22-FC. The following enhancement levels were measured: 22-FC (in Hounsfield-Units (HU)): RV = 203±29, LV = 523±36, RA = 198±29, LA = 519±38, RCA = 547±26, LM = 562±25; 18-NFC: RV = 146±26, LV = 464±32, RA = 141±24, LA = 438±35, RCA = 501±23, LM = 523±23; RV (p = 0,03), LV (p = 0.12), RA (p = 0.02), LA (p = 0.04), RCA (p = 0.3), LM (p = 0.33).

Conclusion: No significant differences in attenuation levels as well as in image quality of the coronary arteries were found between NFC and FC. Nevertheless, the 22-gauge FC examinations showed significantly higher attenuation in the left and right atrium as well as the right ventricle. Patients with poor venous access may benefit from a smaller gauge catheter that can deliver sufficiently high flow rates for CCTA.

PubMed Disclaimer

Conflict of interest statement

Dr. Schoenberg reports that the institute of clinical radiology and nuclear medicine has research agreements with Siemens Healthcare GmbH. Dr. Schoepf receives institutional research support from Astellas, Bayer, and Siemens. Dr. Schoepf has received consulting fees and or speaker honoraria from Bayer, Elucid BioImaging, GE, Guerbet, HeartFlow Inc., and Siemens. UMCG receives institutional research support from Siemens. The other authors have no conflict of interest to disclose. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Comparison of both catheter systems.
On the left side the catheter system with side holes is shown (22-gauge fenestrated). The figure above illustrates the flow technique after intravenous application as a model. On the righthand side a conventional catheter system (18-gauge non-fenestrated) with only one terminal hole is shown.
Fig 2
Fig 2. 56-year-old male with a relevant cardiovascular risk profile (diabetes mellitus, arterial hypertension, hypertensive and diabetic nephropathy).
Indication for CCTA due to intermittent chest pain; contrast medium application via 22-FC. Schematic presentation of the HU measurements taken via ROI in two different axial slices. Fig 2 A shows the HU measurement in the ascending aorta (blue) and in the LM (red). Fig 2 B shows the schematic HU measurement for the right (yellow) and left ventricle (black). CCTA = Coronary computed tomography angiography, FC = fenestrated catheter, HU = Hounsfield units, LM = left main coronary artery.
Fig 3
Fig 3. Box plots of different aortic enhancement levels from both catheter-types in Hounsfield Units (HU).
Control = 18-gauge non-fenestrated catheter. Diffusics = 22-gauge fenestrated catheter. LV = left ventricle; LA = left atrium; RV = right ventricle; RA = right atrium; RCA = right coronary artery; LCA = left coronary artery.
See this image and copyright information in PMC

References

    1. Behrendt FF, Pietsch H, Jost G, Sieber MA, Keil S, Plumhans C, et al. Intra-individual comparison of different contrast media concentrations (300 mg, 370 mg and 400 mg iodine) in MDCT. Eur Radiol. 2010;20(7):1644–50. Epub 2010/02/26. 10.1007/s00330-010-1717-7 . - DOI - PubMed
    1. Awai K, Kanematsu M, Kim T, Ichikawa T, Nakamura Y, Nakamoto A, et al. The Optimal Body Size Index with Which to Determine Iodine Dose for Hepatic Dynamic CT: A Prospective Multicenter Study. Radiology. 2016;278(3):773–81. Epub 2015/09/12. 10.1148/radiol.2015142941 . - DOI - PubMed
    1. Silvennoinen HM, Hamberg LM, Lindsberg PJ, Valanne L, Hunter GJ. CT perfusion identifies increased salvage of tissue in patients receiving intravenous recombinant tissue plasminogen activator within 3 hours of stroke onset. AJNR Am J Neuroradiol. 2008;29(6):1118–23. Epub 2008/04/12. 10.3174/ajnr.A1039 . - DOI - PMC - PubMed
    1. Goshima S, Kanematsu M, Nishibori H, Sakurai K, Miyazawa D, Watanabe H, et al. CT of the pancreas: comparison of anatomic structure depiction, image quality, and radiation exposure between 320-detector volumetric images and 64-detector helical images. Radiology. 2011;260(1):139–47. Epub 2011/03/17. 10.1148/radiol.11101459 . - DOI - PubMed
    1. Poole GW. Exercise, coronary heart disease and risk factors. A brief report. Sports Med. 1984;1(5):341–9. Epub 1984/09/01. 10.2165/00007256-198401050-00002 . - DOI - PubMed

Publication types