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Intraarterial CT Angiography Using Ultra Low Volume of Iodine Contrast – Own Experiences

BACKGROUND: High volume of intravenous contrast in CT-angiography may result in contrast-induced nephropathy. Intraarterial ultra-low volume of contrast medium results in its satisfactory blood concentration with potentially good image quality. The first main purpose was to assess the influence of t...

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Autores principales: Garcarek, Jerzy, Kurcz, Jacek, Guziński, Maciej, Banasik, Mirosław, Miś, Marcin, Gołębiowski, Tomasz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4497469/
https://www.ncbi.nlm.nih.gov/pubmed/26191113
http://dx.doi.org/10.12659/PJR.894050
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author Garcarek, Jerzy
Kurcz, Jacek
Guziński, Maciej
Banasik, Mirosław
Miś, Marcin
Gołębiowski, Tomasz
author_facet Garcarek, Jerzy
Kurcz, Jacek
Guziński, Maciej
Banasik, Mirosław
Miś, Marcin
Gołębiowski, Tomasz
author_sort Garcarek, Jerzy
collection PubMed
description BACKGROUND: High volume of intravenous contrast in CT-angiography may result in contrast-induced nephropathy. Intraarterial ultra-low volume of contrast medium results in its satisfactory blood concentration with potentially good image quality. The first main purpose was to assess the influence of the method on function of transplanted kidney in patients with impaired graft function. The second main purpose of the study was to evaluate the usefulness of this method for detection of gastrointestinal and head-and-neck haemorrhages. MATERIAL/METHODS: Between 2010 and 2013 intraarterial CT-angiography was performed in 56 patients, including 28 with chronic kidney disease (CKD). There were three main subgroups: 18 patients after kidney transplantation, 10 patients with gastrointestinal hemorrhage, 8 patients with head-and-neck hemorrhage. Contralateral or ipsilateral inguinal arterial approach was performed. The 4-French vascular sheaths and 4F-catheters were introduced under fluoroscopy. Intraarterial CT was performed using 64-slice scanner. The scanning protocol was as follows: slice thickness 0.625 mm, pitch 1.3, gantry rotation 0.6 sec., scanning delay 1–2 sec. The extent of the study was established on the basis of scout image. In patients with CKD 6–8 mL of Iodixanol (320 mg/mL) diluted with saline to 18–24 mL was administered at a speed of 4–5 mL/s. RESULTS: Vasculature was properly visualized in all patients. In patients with impaired renal function creatinine/eGFR levels remained stable in all but one case. Traditional arteriography failed and CT-angiography demonstrated the site of bleeding in 3 of 10 patients with symptoms of gastrointestinal bleeding (30%). In 8 patients with head-and-neck bleeding CT-angiography did not prove beneficial when compared to traditional arteriography. CONCLUSIONS: 1. Ultra-low contrast intraarterial CT-angiography does not deteriorate the function of transplanted kidneys in patients with impaired graft function. 2. 3D reconstructions allow for excellent visualization of vascular anatomy of renal transplants. 3. Intraarterial CT-angiography is useful for detection of the bleeding site.
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spelling pubmed-44974692015-07-17 Intraarterial CT Angiography Using Ultra Low Volume of Iodine Contrast – Own Experiences Garcarek, Jerzy Kurcz, Jacek Guziński, Maciej Banasik, Mirosław Miś, Marcin Gołębiowski, Tomasz Pol J Radiol Original Article BACKGROUND: High volume of intravenous contrast in CT-angiography may result in contrast-induced nephropathy. Intraarterial ultra-low volume of contrast medium results in its satisfactory blood concentration with potentially good image quality. The first main purpose was to assess the influence of the method on function of transplanted kidney in patients with impaired graft function. The second main purpose of the study was to evaluate the usefulness of this method for detection of gastrointestinal and head-and-neck haemorrhages. MATERIAL/METHODS: Between 2010 and 2013 intraarterial CT-angiography was performed in 56 patients, including 28 with chronic kidney disease (CKD). There were three main subgroups: 18 patients after kidney transplantation, 10 patients with gastrointestinal hemorrhage, 8 patients with head-and-neck hemorrhage. Contralateral or ipsilateral inguinal arterial approach was performed. The 4-French vascular sheaths and 4F-catheters were introduced under fluoroscopy. Intraarterial CT was performed using 64-slice scanner. The scanning protocol was as follows: slice thickness 0.625 mm, pitch 1.3, gantry rotation 0.6 sec., scanning delay 1–2 sec. The extent of the study was established on the basis of scout image. In patients with CKD 6–8 mL of Iodixanol (320 mg/mL) diluted with saline to 18–24 mL was administered at a speed of 4–5 mL/s. RESULTS: Vasculature was properly visualized in all patients. In patients with impaired renal function creatinine/eGFR levels remained stable in all but one case. Traditional arteriography failed and CT-angiography demonstrated the site of bleeding in 3 of 10 patients with symptoms of gastrointestinal bleeding (30%). In 8 patients with head-and-neck bleeding CT-angiography did not prove beneficial when compared to traditional arteriography. CONCLUSIONS: 1. Ultra-low contrast intraarterial CT-angiography does not deteriorate the function of transplanted kidneys in patients with impaired graft function. 2. 3D reconstructions allow for excellent visualization of vascular anatomy of renal transplants. 3. Intraarterial CT-angiography is useful for detection of the bleeding site. International Scientific Literature, Inc. 2015-07-05 /pmc/articles/PMC4497469/ /pubmed/26191113 http://dx.doi.org/10.12659/PJR.894050 Text en © Pol J Radiol, 2015 This is an open access article. Unrestricted non-commercial use is permitted provided the original work is properly cited.
spellingShingle Original Article
Garcarek, Jerzy
Kurcz, Jacek
Guziński, Maciej
Banasik, Mirosław
Miś, Marcin
Gołębiowski, Tomasz
Intraarterial CT Angiography Using Ultra Low Volume of Iodine Contrast – Own Experiences
title Intraarterial CT Angiography Using Ultra Low Volume of Iodine Contrast – Own Experiences
title_full Intraarterial CT Angiography Using Ultra Low Volume of Iodine Contrast – Own Experiences
title_fullStr Intraarterial CT Angiography Using Ultra Low Volume of Iodine Contrast – Own Experiences
title_full_unstemmed Intraarterial CT Angiography Using Ultra Low Volume of Iodine Contrast – Own Experiences
title_short Intraarterial CT Angiography Using Ultra Low Volume of Iodine Contrast – Own Experiences
title_sort intraarterial ct angiography using ultra low volume of iodine contrast – own experiences
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4497469/
https://www.ncbi.nlm.nih.gov/pubmed/26191113
http://dx.doi.org/10.12659/PJR.894050
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