Removal of contrast medium from the coronary sinus during coronary angiography: feasibility of a simple and available technique for the prevention of nephropathy

Cardiovascular Revascularization Medicine : Including Molecular Interventions
Haim D DanenbergA Teddy Weiss

Abstract

Contrast-induced nephropathy (CIN) is a major complication of percutaneous coronary interventions with currently limited preventive measures. To prevent CIN, we assessed the safety and feasibility of contrast removal from the coronary sinus (CS) during coronary angiography. We attempted contrast removal on seven patients undergoing coronary angiography with preexisting renal insufficiency (mean serum creatinine=262+/-56 mg%). In four patients, a balloon catheter could not be successfully deployed in the CS. In three patients, a balloon catheter with distal side holes was positioned in the CS orifice. The balloon was inflated to occlude the CS concurrent with coronary injections, and 12-16 ml of blood was aspirated after each injection. The procedure appeared to be safe, without adverse events and elevations of serum creatinine levels. Contrast media were effectively withdrawn (44%+/-8%) as assessed by fluoroscopy and dilution of blood. The increased venous pressure at the time of injection reduced coronary flow, allowing for small volumes of administered contrast. Occlusion of the CS during coronary angiography with aspiration of contrast media is safe and effective in reducing contrast load during coronary interventions. This ...Continue Reading

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Citations

Oct 26, 2013·Current Heart Failure Reports·Guido BoerrigterHarald Lapp
May 6, 2014·BioMed Research International·Paweena Susantitaphong, Somchai Eiam-Ong
Oct 5, 2013·Journal of the Chinese Medical Association : JCMA·Chao-Fu Chang, Chih-Ching Lin
Mar 30, 2010·Cardiovascular Revascularization Medicine : Including Molecular Interventions·Ali H M HassanPeter J Fitzgerald
May 15, 2010·Journal of Interventional Cardiology·Alessandro Mautone, Jeremiah R Brown
Jun 20, 2012·American Heart Journal·Israel M BarbashRon Waksman
Jan 5, 2017·Circulation. Cardiovascular Interventions·Richard Solomon, Harold L Dauerman
Dec 7, 2019·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Chaim Lotan
Sep 6, 2020·Life Sciences·Fangfei ZhangFeng Wang

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