Author + information
- Cinzia Moncalvo1,
- Vincenzo Puma1,
- Giuseppe Celano2,
- Angelo Laurenza1,
- Giuseppe Carosio1 and
- Paolo Cioffi1
the El Gamal is a very flexible, precurved catheter, with gentle curve, tapered soft tip, with two little side holes and a bigger hole on its top. It is available in three sizes: 1-2-3 (® Cordis). The El Gamal is a universal catheter used to perform angiography of both right and left coronary. It allows: the use of a single catheter, reduction in time of fluoroscopy and in medium contrast, easily crossing of the vessel tortuosity and it doesn't cause important vasospasm.
to compare coronary angiography performed using radial artery approach with El Gamal or Judkins catheter.
we compared 1000 patients who underwent coronary angiography, 500 examinations were performed using El Gamal technique and 500 using Judkins technique.
Mean time of examination (minutes) after radial artery puncture: 5.7 minutes with the El Gamal and 6.8 minutes with the Judkins technique. Mean time of fluoroscopy (minutes): 3,8 minutes with the El Gamal and 3,9 minutes with the Judkins. Mean contrast medium (ml): 55 ml with the El Gamal, 62 ml with the Judkins. With the El Gamal technique the coronary angiography was performed using only one catheter in 74% of the patients, using two catheters in 10% of the patients and three or more catheters in 16% of the patients. With Judkins tecnique the coronary angiography was performed using two catheters in 84% of the patients, in 10% of the patients we used three or more catheters. Technical problems were: radial artery's spasm in 9% of the patients with the Judkins technique (2% with the El Gamal). Difficulty in crossing vessels' tortuosity in 9% of the patients with the Judkins' technique (6% solved using the El Gamal catheter), only 1% of the patient with the El Gamal. No complications occurred in both groups.
In our study this technique with only one El Gamal catheter is effective in 74% of the cases. It reduces the time of examination significantly and limits the time of fluoroscopy. It allows the saving of the catheters used and it's very useful in case of extreme vessels' tortuosity.