Carbon dioxide Angiography-Guided Renal-Related Interventions in Patients with Takayasu Arteritis and Renal Insufficiency

BACKGROUND: Use of iodinated contrast agents for angiography in patients with renal insufficiency risks further deterioration of renal function and its adverse sequelae. OBJECTIVE: To study the effectiveness and safety of carbon dioxide (CO(2)) angiography in guiding percutaneous renal-related inter...

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Autores principales: Chacko, Sujith, Joseph, George, Thomson, Viji, George, Paul, George, Oommen, Danda, Debashish
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5976698/
https://www.ncbi.nlm.nih.gov/pubmed/29549415
http://dx.doi.org/10.1007/s00270-018-1936-x
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author Chacko, Sujith
Joseph, George
Thomson, Viji
George, Paul
George, Oommen
Danda, Debashish
author_facet Chacko, Sujith
Joseph, George
Thomson, Viji
George, Paul
George, Oommen
Danda, Debashish
author_sort Chacko, Sujith
collection PubMed
description BACKGROUND: Use of iodinated contrast agents for angiography in patients with renal insufficiency risks further deterioration of renal function and its adverse sequelae. OBJECTIVE: To study the effectiveness and safety of carbon dioxide (CO(2)) angiography in guiding percutaneous renal-related interventions in patients with Takayasu arteritis and renal insufficiency. METHODS: Data on CO(2) angiography-guided interventions were obtained from a 23-year database of 692 Takayasu arteritis patients who underwent percutaneous interventions and were analyzed retrospectively. Follow-up data were also obtained. The CO(2) angiography system used was developed in-house and was pressure-driven. RESULTS: Seven patients (6 female, age 16–59 years, baseline serum creatinine 1.62–4.55 mg/dl, estimated glomerular filtration rate 12.2–36.9 ml/min/1.73 m(2)) underwent CO(2) angiography-guided interventions: five underwent angioplasty or stenting to treat six stenotic/occluded renal arteries, one underwent extensive endovascular repair for spontaneous focal abdominal aortic dissection with false lumen aneurysm and aorto-iliac true lumen narrowing, and one underwent balloon dilatation of previously deployed aortic stents used to treat aortic occlusion at two levels. Follow-up (median 5 years, range 2 months–16 years) was obtained in all patients. All the procedures were successful and resulted in relief of symptoms, better blood pressure control, improvement in left ventricular systolic function and recovery or stabilization of renal function. There were no early or late complications related to CO(2) angiography. Three renal lesions that had restenosis at follow-up were managed successfully by repeat intervention. CONCLUSION: CO(2) angiography-guided renal-related interventions are effective and safe in patients with Takayasu arteritis and renal insufficiency; they significantly improve the care of such patients.
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spelling pubmed-59766982018-06-08 Carbon dioxide Angiography-Guided Renal-Related Interventions in Patients with Takayasu Arteritis and Renal Insufficiency Chacko, Sujith Joseph, George Thomson, Viji George, Paul George, Oommen Danda, Debashish Cardiovasc Intervent Radiol Clinical Investigation BACKGROUND: Use of iodinated contrast agents for angiography in patients with renal insufficiency risks further deterioration of renal function and its adverse sequelae. OBJECTIVE: To study the effectiveness and safety of carbon dioxide (CO(2)) angiography in guiding percutaneous renal-related interventions in patients with Takayasu arteritis and renal insufficiency. METHODS: Data on CO(2) angiography-guided interventions were obtained from a 23-year database of 692 Takayasu arteritis patients who underwent percutaneous interventions and were analyzed retrospectively. Follow-up data were also obtained. The CO(2) angiography system used was developed in-house and was pressure-driven. RESULTS: Seven patients (6 female, age 16–59 years, baseline serum creatinine 1.62–4.55 mg/dl, estimated glomerular filtration rate 12.2–36.9 ml/min/1.73 m(2)) underwent CO(2) angiography-guided interventions: five underwent angioplasty or stenting to treat six stenotic/occluded renal arteries, one underwent extensive endovascular repair for spontaneous focal abdominal aortic dissection with false lumen aneurysm and aorto-iliac true lumen narrowing, and one underwent balloon dilatation of previously deployed aortic stents used to treat aortic occlusion at two levels. Follow-up (median 5 years, range 2 months–16 years) was obtained in all patients. All the procedures were successful and resulted in relief of symptoms, better blood pressure control, improvement in left ventricular systolic function and recovery or stabilization of renal function. There were no early or late complications related to CO(2) angiography. Three renal lesions that had restenosis at follow-up were managed successfully by repeat intervention. CONCLUSION: CO(2) angiography-guided renal-related interventions are effective and safe in patients with Takayasu arteritis and renal insufficiency; they significantly improve the care of such patients. Springer US 2018-03-16 2018 /pmc/articles/PMC5976698/ /pubmed/29549415 http://dx.doi.org/10.1007/s00270-018-1936-x Text en © The Author(s) 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Clinical Investigation
Chacko, Sujith
Joseph, George
Thomson, Viji
George, Paul
George, Oommen
Danda, Debashish
Carbon dioxide Angiography-Guided Renal-Related Interventions in Patients with Takayasu Arteritis and Renal Insufficiency
title Carbon dioxide Angiography-Guided Renal-Related Interventions in Patients with Takayasu Arteritis and Renal Insufficiency
title_full Carbon dioxide Angiography-Guided Renal-Related Interventions in Patients with Takayasu Arteritis and Renal Insufficiency
title_fullStr Carbon dioxide Angiography-Guided Renal-Related Interventions in Patients with Takayasu Arteritis and Renal Insufficiency
title_full_unstemmed Carbon dioxide Angiography-Guided Renal-Related Interventions in Patients with Takayasu Arteritis and Renal Insufficiency
title_short Carbon dioxide Angiography-Guided Renal-Related Interventions in Patients with Takayasu Arteritis and Renal Insufficiency
title_sort carbon dioxide angiography-guided renal-related interventions in patients with takayasu arteritis and renal insufficiency
topic Clinical Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5976698/
https://www.ncbi.nlm.nih.gov/pubmed/29549415
http://dx.doi.org/10.1007/s00270-018-1936-x
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