Abstract 16677: A Novel Angiography Technique Reduces CIN Development Through the Delivery of Ultra-Low Contrast Volumes
Background: Contrast induced nephropathy (CIN) is an iatrogenic complication related to iodinated contrast exposure. The incidence of CIN is highest (15%) in patients with concomitant renal disease. We suggest that the delivery of ultra-low contrast volumes—using a novel automated injector system technique—effectively reduces CIN incidence compared to a low volume contrast cohort (Mayo Clinic data).
Methods and Results: A retrospective analysis of the Sanford Cardiovascular Institute angiography lab registry was performed in order to evaluate the incidence of CIN following diagnostic angiography in patients with CKD. CIN was defined as an increase in serum creatinine by 0.5 mg/dL or > 25% from baseline through 7 days. All patients with CKD stages III to V had undergone coronary angiography using the ultra-low contrast delivery technique (ULCD). The incidence of CIN following diagnostic angiography with the ULCD technique was compared to the rates observed in the Mayo Cohort (which evaluated CKD patients using a low volume contrast delivery technique (LVCD)). ULCD was achieved using novel contrast preservation techniques previously published.
Of the 80 sequential patients who had undergone diagnostic angiography, the average contrast volume was 15 mls, compared to 27 mls used in the Mayo Cohort. The incidence of CIN in the ULCD group was 4% (3/80) compared to 15% (28/185) in the LVCD cohort (2-sided Fisher exact test, p = .0066).
Conclusion: The overall incidence of CIN in patients with significant CKD is reduced using an ULCD technique compared to historical data. Consistent delivery of volumes <15 mls during diagnostic angiography is feasible using the novel programming techniques for an ACIS device. ULCD technique appears to be an effective method of preserving renal function in a CIN susceptible population.
Author Disclosures: S. Kelly: None. T. Stys: None. P. Thompson: None. A. Stys: None.
- © 2014 by American Heart Association, Inc.