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We assessed a method for reducing iodized contrast volume in aortic computed tomography angiography (CTA) using a contrast volume calculator and a spiral flow device. Sixty patients undergoing aortic CTA were randomly assigned to 4 groups. Group 1 received a patient specific calculated contrast volume based on weight, length and heart rate; group 2 a 20% dilution, groups 3 and 4 a 50% dilution of the calculated volumes. A spiral flow device was used to mix contrast agent and saline. The first 3 groups were scanned on a Siemens Somatom Flash, group 4 on a Somatom Force with improved tube voltage modulation. Aortic contrast density was measured and image quality was evaluated using visual grading analysis (VGA). Mean contrast volumes for groups 1 to 4 were respectively 93, 78, 52 and 44 ml. Mean tube voltage was 27% lower in group 4 compared to the other groups (P < 0,0001). Contrast densities between groups 1, 2 and 4 were not significantly different (P > 0.05). Mean density in group 3 was 42% lower than group 1 (P < 0.001) and 31% lower than group 2 (P < 0.01). Mean density in group 4 was 52% higher than group 3 (P < 0.001). VGA score for group 3 was significantly lower than the other groups. In conclusion we can state that low patient tailored contrast volumes can yield good image quality in aortic CTA using scan protocols combining contrast dilution up to 50%, a spiral flow device and reduced tube voltage.