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The Usefulness of Fenestrated Intravenous Catheters Compared With Nonfenestrated Catheter for Cardiac Multidetector Computed Tomography

Kim, JeongJae, MD*†; Kim, Eun Jeong, MS; Hur, Jee Hye, MD; Ham, Jin Ok, PhD; Kim, Yeo Koon, MD; Choi, Sang Il, MD, PhD

Journal of Computer Assisted Tomography: May/June 2019 - Volume 43 - Issue 3 - p 423–427
doi: 10.1097/RCT.0000000000000855
Cardiothoracic and Breast Imaging
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Purpose To compare the fenestrated intravenous (IV) catheter and nonfenestrated conventional IV catheter in terms of contrast enhancement and injection pressure for coronary computed tomography angiography.

Methods Three hundred patients were prospectively and consecutively enrolled to either the 20-gauge nonfenestrated conventional (group 1) IV catheter group or the 20-gauge fenestrated (group 2) or 22-gauge fenestrated (group 3) IV catheter groups. We analyzed mean vascular attenuations in the ascending aorta, left main coronary artery, left ventricular (LV) cavity, and descending aorta. Injection pressure using pound-force per square inch (PSI) and extravasation of contrast media were recorded.

Results Mean attenuations of the left main coronary artery, LV cavity, and descending aorta were significantly higher in group 2 than in group 1 (P ≤ 0.001, P ≤ 0.001, P ≤ 0.001, respectively). Moreover, injection pressure was significantly lower in group 2 than in group 1 (208.3 vs 216.9 PSI, P = 0.006). Mean vascular attenuations of the left main coronary artery, LV cavity, and descending aorta were significantly higher in group 3 than in group 1 (P = 0.016, P = 0.029, P = 0.001, respectively). However, injection pressure was not statistically significant between group 3 and group 1 (213.6 vs 216.9 PSI, P = 0.355). No extravasation occurred in any patient groups during the study.

Conclusions We suggest that fenestrated IV catheter is useful in terms of higher vascular attenuation and lower injection pressure for coronary computed tomography angiography. It has a potential merit in patients with fragile and small veins.

From the *Department of Radiology, Jeju National University Hospital, Jeju;

Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center, Seongnam; and

Department of Radiology, Hanil General Hospital, Seoul, Korea.

Received for publication May 19, 2018; accepted September 18, 2018.

Correspondence to: Sang Il Choi, MD, PhD, Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Korea (e-mail: drsic@hanmail.net; sichoi@snu.ac.kr).

This work was supported by the Seoul National University Bundang Hospital Research Fund (no. 03-2012-018) and BD (Franklin Lakes, NJ).

BD (Franklin Lakes, NJ) was involved in the design and conduct of the study and provided fenestrated intravenous catheter. Employees of the sponsor worked with the investigators to prepare the statistical analysis plan, but the efficacy analyses were performed by an independent radiologic committee of Seoul National University Bundang Hospital.

This study was approved by our institutional review board (B-1510/318-002).

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