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1. Traditional versus automated injection contrast system in diagnostic and percutaneous coronary interventional procedures: Comparison of the contrast volume delivered. Anne G, Gruberg L, Huber A, Nikolsky E, et al. Journal of Invasive Cardiology 2004; 16:360-362.
   
   453 consecutive patients undergoing DCA, DCA + PCI, and PCI at one institution were randomly assigned to a manual technique (n=200) or to the ACIST System (n=253) for contrast injection. The manual method used in the control group required the usual repetitive manipulation of the stopcock-manifold system and contrast injection by hand syringe with left ventriculography performed in these patients by attachment to a (non-variable) power injector.
   
   
2. Saving time, saving money: A time and motion study with contrast management systems. Lehmann C, Hotaling M. Journal of Invasive Cardiology 2005 Feb; 17(2):118-121.
   
   Data was collected from five catheterization labs over a two day period from nonrandomized patients undergoing routine diagnostic catheterization by manual techniques (n=53) or by the variable-rate, automated ACIST system (n=90). Equipment setup time, contrast waste disposal and arterial time for each test condition were recorded. Procedure workflow was more efficient and contrast media waste was significantly less in the catheterization labs using the ACIST system.
   
   
3. Coronary angiography using 4 Fr catheters with ACISTed power injection: A randomized comparison to 6 Fr manual technique and early ambulation. Khoukaz S, Kern MJ, Bitar SR, et al. Catheterization and Cardiovascular Interventions 2001 Mar; 52:393-398.
   
   Unselected patients were randomized to transfemoral coronary angiography with 6 Fr (manual contrast injection, n=54) or 4 Fr (ACIST System, n=47). Procedural characteristics, angiographic quality scores and the results of 90 minute ambulation were analyzed and compared. Compared to 6 Fr manual contrast injection technique, diagnostic angiography through 4 Fr catheters with the ACIST resulted in equivalent angiographic quality, slightly reduced but diagnostically acceptable left ventricular image quality, and significantly less contrast volume.
   
   
4. Randomized comparison of coronary angiography using 4F catheters: 4F manual versus “ACISTed” power injection technique. Chahoud G, Khoukaz S, El-Shafei A, Azrak E, Bitar S, Kern MJ. Catheterization and Cardiovascular Interventions 2001; 53(2): 221-224.
   
   Unselected patients undergoing transfemoral coronary angiography with 4F catheters were randomized to either the ACIST variable-rate contrast injection system (n=47) or to manual techniques (n=49). Procedural characteristics and angiographic quality scores were analyzed. Compared with the 4F manual contrast injection technique, diagnostic angiography through 4F catheters with the ACIST resulted in equivalent coronary angiographic image quality with significantly less radiographic contrast volume.
   
   
5. The ACIST Power Injection System reduces the amount of contrast media delivered to the patient, as well as fluoroscopy time during diagnostic and interventional cardiac procedures. Brosh D, Assali A, Fuchs S, et al. International Journal of Cardiovascular Interventions 2005; 7(4):183-187.
   
   Consecutive patients who underwent diagnostic coronary angiography and/or angioplasty were randomly assigned to either manual contrast injection (control, n=198) or to the ACIST System (study group, n=257). Routine utilization of the ACIST System during diagnostic and interventional procedures significantly reduced the total amount of contrast media used and fluoroscopy time.
   
   
6. A novel automated injection system for angiography. Goldstein JA, Kern M, Wilson R. Journal of Interventional Cardiology 2001; 14:147–152.
   
   The ACIST system was evaluated in 50 patients undergoing diagnostic coronary angiography (n = 37) or coronary interventions (n = 13). The system was easy to use and provided excellent quality images even with 4 Fr catheters, as well as imaging during stent positioning with 6 Fr guides. This variable-rate, automated injector facilitates precision operator-controlled angiographic injections, provides superb high quality coronary images even with very small lumen catheters, and expedites ventriculography during angiographic procedures.
   
   
7. Early ambulation strategies with contrast management. Lim MJ. Journal of Invasive Cardiology 2005 Jan; 17(1): 42-43.
   
   This article reviews catheter size, the use of closure devices and contrast-induced nephropathy in light of the known and potential advantages of using the ACIST System.
   
   
8. Interventional and Peripheral Vascular Procedures Using Contrast Management: Tips and Techniques. Kern MJ. Journal of Invasive Cardiology 2004 Dec; 16(12):729-731.
   
   Defines the optimal contrast injection system and analyzes manual and ACIST System power injection in light of optimizing diagnostic and interventional catheterization.
   
   
9. Contrast delivery and patient safety during peripheral interventions. Laird JR. Journal of Invasive Cardiology 2006; 18(Suppl A): 21A-25A.
   
   Discussion article on the need for optimal imaging and minimizing contrast amount in the endovascular suite during peripheral arterial diagnostic and interventional procedures. Author relates the role of the ACIST system for these procedures.
   
   
10. Automated contrast injection and targeted renal therapy: Strategies to prevent contrast-induced nephropathy and treat renal insufficiency in patients with peripheral arterial disease. Allie DE, Hebert CJ, Walker CM. Vascular Disease Management 2006; 3(3):1-7.
    
    Discussion article based on authors’ experience in treating patients with peripheral arterial disease during percutaneous peripheral interventions. Discusses strategies of using the ACIST injection system, targeted renal therapy, and revised MDCTA protocols.
    
    
11. Automated contrast injection in contemporary practice during cardiac catheterization and PCI: Effects on contrast-induced nephropathy. Call J, Sacrinty M, Applegate R, et al. Journal of Invasive Cardiology 2006; 18(10):469-474.
    
    Retrospective, observational study evaluating N= 2,175 patients from 2002-04 (n= 1798 patients using traditional hand injection techniques from Apr 2002 – Jan 2004 and n=377 patients using ACIST Contrast Delivery System from Jan–Nov 2004). Shows that use of lower volumes of contrast media while using the ACIST Contrast Delivery System is associated with a reduced relative risk of Contrast Induced Nephropathy (CIN) when compared to traditional hand injection techniques.
    
    
12. Advances in patient care: clinicians report on their use of a variable-rate, contrast injection system. Cath Lab Digest Dec 2007(Suppl);15(12):1-11.
    
    Case study articles highlighting three different cath lab experiences using the ACIST contrast injection system for angiography at their facilities.