A Novel Contrast Removal System From the Coronary Sinus Using an Adsorbing Column During Coronary Angiography in a Porcine Model

Michishita, Ichiro; Fujii, Zenzo

doi:10.1016/j.jacc.2005.11.080

Cited by 23 publications

(11 citation statements)

References 15 publications

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“…Future approaches include large planned studies of oral and intravenous antioxidants (including a potent oral antioxidant, deferiprone), intrarenal infusions of renal vasodilators using flow directed catheters, forced hydration with marked elevations of urine output to reduce the transit time of iodinated contrast in the renal tubules, systemic cooling, and novel, hopefully less toxic, forms of radio-opaque contrast agents. Another novel approach may involve coronary sinus withdrawal of blood and contrast after intracoronary injection, thus reducing the volume of contrast delivered downstream to the kidneys (73,74). If Advanced Algorithm for Management of Patients Receiving Iodinated Contrast Media cardiovascular procedures could be performed with no risk of AKI, it is expected that major adverse cardiac and medical complications could be appreciably reduced.…”

Section: Future Preventive Approachesmentioning

confidence: 99%

Contrast-Induced Acute Kidney Injury

McCullough

2008

Journal of the American College of Cardiology

808

475

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Cardiac angiography and coronary/vascular interventions depend on iodinated contrast media and consequently pose the risk of contrast-induced acute kidney injury (AKI). This is an important complication that accounts for a significant number of cases of hospital-acquired renal failure, with adverse effects on prognosis and health care costs. The epidemiology and pathogenesis of contrast-induced AKI, baseline renal function measurement, risk assessment, identification of high-risk patients, contrast medium use, and preventive strategies are discussed in this report. An advanced algorithm is suggested for the risk stratification and management of contrast-induced AKI as it relates to patients undergoing cardiovascular procedures. Contrast-induced AKI is likely to remain a significant challenge for cardiologists in the future because the patient population is aging and chronic kidney disease and diabetes are becoming more common.

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Section: Future Preventive Approachesmentioning

confidence: 99%

Contrast-Induced Acute Kidney Injury

McCullough

2008

Journal of the American College of Cardiology

808

475

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“…Future approaches include large planned studies of oral and intravenous antioxidants (including a potent oral antioxidant, deferiprone), intrarenal infusions of renal vasodilators using flow directed catheters in the procedural suite or intensive care unit, forced hydration using a balancing pump with marked elevations of urine output to reduce the transit time of iodinated contrast in the renal tubules, systemic cooling, and novel, hopefully less toxic forms of radiopaque contrast agents. Another approach may involve coronary sinus withdrawal of blood and contrast after intracoronary injection, thus reducing the volume of contrast delivered downstream to the kidneys [85, 86]. If procedures using iodinated contrast could be performed with no risk of AKI, it is expected that major medical complications and death could be appreciably reduced.…”

Section: Future Approachesmentioning

confidence: 99%

Radiocontrast-Induced Acute Kidney Injury

McCullough¹

2008

Nephron Physiol

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Many radiographic studies and procedures use iodinated contrast media and consequently pose the risk of contrast-induced acute kidney injury (AKI). This is an important complication, which accounts for a significant number of cases of hospital-acquired renal failure associated increased hospital length of stay and increased mortality. Sustained reductions in renal blood flow, hypoxic injury, direct cellular toxicity by the contrast media, and superimposed organ injury are all believed to play a role in this form of AKI. Avoidance of dehydration and multimodality prevention measures may reduce rates of this problem in patients at risk. Contrast-induced AKI is likely to remain a significant challenge for specialists in the future since the patient population is aging, chronic kidney disease and diabetes are coming more common, and use of iodinated contrast is growing.

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“…On the other hand, Marenzi et al [15] reported the efficacy and safety of periprocedural hemofiltration (HF). We previously reported the efficacy of a contrast removal system from the coronary sinus using an adsorbing column during CAG [16]. This suggests the possibility of blood suction from the right atrium for hemodiafiltration (HDF).…”

Section: Introductionmentioning

confidence: 99%