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

Abstract

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.

Is a 20 gauge fenestrated intravenous catheter non‐inferior to a 18 gauge standard catheter for apheresis procedures? A pilot study

“…Power injectable PIVs have predominantly been used in the radiology setting in order to deliver contrast during computerized tomography (CT) scans. They have been increasingly used in the cardiac computed tomography angiography (CCTA) setting to improve coronary enhancement to diagnose coronary artery stenosis 11,12,16 . The 20G catheter used in this study was approved by the FDA in 2016, and has been used in CCTA to inject contrast at rates of 4 to 5 mL/s 11 .…”

“…They have been increasingly used in the cardiac computed tomography angiography (CCTA) setting to improve coronary enhancement to diagnose coronary artery stenosis 11,12,16 . The 20G catheter used in this study was approved by the FDA in 2016, and has been used in CCTA to inject contrast at rates of 4 to 5 mL/s 11 . This catheter is designed to deliver higher flow rates than a conventional catheter of the same gauge by incorporating three tear‐shaped fenestrations near the tip of the catheter.…”

“…Fenestrated catheters have been increasingly used to deliver high‐pressure injections of contrast during radiologic procedures. Their design, with side holes, may confer benefit by reducing pressures at the exit site, in addition to stabilizing the catheter in the vein and minimizing vein trauma 11,12 . This study aims to demonstrate non‐inferiority of a 20G fenestrated power injectable PIV catheter compared to our institution's standard of care (conventional 18G PIV catheter).…”

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

“…Although the abdominal aorta was examined in this study and different catheter sizes were used when compared to our study focusing on the coronary arteries, the results are similar. To our knowledge only one study explored the feasibility of NFCs in cardiac imaging before [24]. Kim et al compared 20-gauge NFCs and 22-gauge FCs in the context of cardiac imaging.…”