What question did this study set out to answer?

The research aims to evaluate the effectiveness of a closed-circuit dual-port injector system in contrast delivery for cerebral angiography, comparing it to traditional manual methods.

April 21, 2026Open Access

Closed-Circuit Dual-Port Injector System for Fully Automated Contrast Delivery in Diagnostic Cerebral Angiography

Puntos clave

The research aims to evaluate the effectiveness of a closed-circuit dual-port injector system in contrast delivery for cerebral angiography, comparing it to traditional manual methods.
Conducted a retrospective comparative cohort study with 19 patients using automated foot pedal-controlled injections versus 19 historical controls using manual injections.
Measured outcomes included procedure time, fluoroscopy time, radiation dose, and contrast utilization for both groups.
The automated system significantly reduced procedure time per vessel by 39%, from 18.9 to 11.5 minutes (P=0.010).
Both groups achieved diagnostic adequacy, with no complications reported and no significant differences in fluoroscopy time or radiation dose.
A trend towards improved contrast efficiency in the automated group, although not statistically significant, was noted.

Resumen

Purpose: During diagnostic cerebral angiography, catheter navigation requires manual contrast “puff” injections, while subsequent 2D/3D runs often use automated power injectors. Using power injectors for navigation puffs has not been described. We present a closed-circuit dual-port injector system (Nemoto Press Duo Elite) that integrates both navigation puff delivery and diagnostic run injection into a single automated platform, eliminating all manual tableside contrast handling. A foot pedal interface enables operator-controlled puff timing, potentially reducing contrast waste and air embolism risk while improving single-operator ergonomics with future remote robotic implications.Materials and Methods: This retrospective comparative cohort study compared 19 consecutive patients undergoing diagnostic cerebral angiography with foot pedal-controlled puff injections (June–July 2023) to 19 historical controls using manual hand injections (May 2021). Both groups used 90% contrast concentration. Fluoroscopy time, radiation dose, contrast utilization, and safety outcomes were compared.Results: Groups were demographically matched (mean age 52.1±14.2 vs. 50.2±12.9 years; 73.7% female). All 38 procedures achieved diagnostic adequacy with no complications. The foot pedal group demonstrated significantly shorter procedure time per vessel (11.5±4.4 vs. 18.9±10.5 min/vessel, P=0.010) with no significant differences in fluoroscopy time (P=0.171), radiation dose (P=0.690), or contrast delivered (88.7±30.9 vs. 88.2±42.5 mL, P=0.966). A trend toward improved contrast efficiency was observed (23.4±9.4 vs. 27.4±10.4 mL/vessel, P=0.226). Despite undergoing significantly more 3D rotational runs (1.3±1.0 vs. 0.6±0.7, P=0.030), the foot pedal group maintained comparable safety metrics, strengthening the non-inferiority findings.Conclusion: A closed-circuit dual-port injector system integrating automated navigation puff delivery with diagnostic run injection demonstrates non-inferiority to manual injection for diagnostic cerebral angiography, with shorter procedure time per vessel (39% reduction, P=0.010), though interpretation is limited by differences in indication distribution. By eliminating manual tableside contrast handling, this approach enables precise digital contrast accounting and reduces air embolism risk, establishing a foundation for remote and robotic angiography applications.

Me gusta

Guardar

Ver artículo completo