Endovascular aortic aneurysm repair with carbon dioxide-guided angiography in patients with renal insufficiency

Journal of Vascular Surgery
Enrique CriadoGuillermo A Escobar

Abstract

Renal dysfunction following endovascular abdominal aortic aneurysm repair (EVAR) remains a significant source of morbidity and mortality. We studied the use of carbon dioxide (CO(2)) as a non-nephrotoxic contrast agent for EVAR. Recorded data from 114 consecutive patients who underwent EVAR with CO(2) as the contrast agent over 44 months were retrospectively analyzed. CO(2) was used exclusively in 72 patients and in an additional 42 patients iodinated contrast (IC) was given (mean, 37 mL). Renal and hypogastric artery localization and completion angiography were done with CO(2) in all patients, including additional arterial embolization in 16 cases. Preoperative National Kidney Foundation glomerular filtration rate (GFR) classification was normal in 16 patients, mildly decreased in 52, moderate to severely decreased in 44, and two patients were on dialysis. All graft deployments were successful with no surgical conversions. CO(2) angiography identified 20 endoleaks (two type 1, 16 type 2, and two type 4) and three unintentionally covered arteries. Additional use of IC in 42 patients did not modify the procedure in any case. When compared with a cohort of patients who underwent EVAR using exclusively IC, the operative time was s...Continue Reading

References

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Citations

Feb 3, 2016·Journal of Vascular and Interventional Radiology : JVIR·Vania TacherHicham Kobeiter
Jan 27, 2015·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·A KaladjiP Haigron
Sep 16, 2015·Journal of Vascular Surgery·J Hunter MehaffeyGilbert R Upchurch
Feb 8, 2014·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Robert P GarvinDavid P Franklin
Jun 5, 2013·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Athanasios N SaratzisAsif Mahmood
Sep 28, 2016·Annals of Vascular Surgery·Cynthia de Almeida MendesNelson Wolosker
Oct 6, 2014·Journal of Vascular Surgery·David C OrmesherJonathan Ghosh
Sep 19, 2015·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Giasemi KoutouziMårten Falkenberg
Sep 28, 2017·Journal of Intensive Care Medicine·Anna P SattahShawn Sarin
Oct 29, 2015·Vascular Specialist International·Kyung Jae Cho
Oct 4, 2012·Current Opinion in Cardiology·Felix J V Schlösser, Bart E Muhs
May 10, 2019·Der Radiologe·F PedersoliT Schmitz-Rode
Dec 15, 2020·The Journal of Cardiovascular Surgery·Diletta LoschiGermano Melissano
Jul 23, 2021·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Nikolaos FlorosMarkus Udo Wagenhäuser
Aug 10, 2021·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Emiliano ChisciNicola Troisi
Nov 6, 2021·World Journal of Emergency Surgery : WJES·Ryo YamamotoJunichi Sasaki

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