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Minimierung kontrastmittelinduzierter Nephropathien Strategien bei CTA, Katheterangiographie und Interventionen

Nyman, Ulf LU (2011) In Gefässchirurgie 16(7). p.469-469
Abstract
The aim of the present paper is to discuss strategies to minimize contrast medium (CM) doses in patients at risk of CM-induced nephropathy (CIN) after computed tomographic angiography (CTA), and percutaneous catheter angiography (PCA) and vascular interventions (PVI). In general a gram-iodine (g-I)/eGFR ratio >= 1.0 appears to be a significant and independent predictor of CIN in CTA and coronary interventions. In high CIN-risk patients (e.g., eGFR < 45 ml/min or multiple risk factors), it is recommended to keep the g-I/eGFR ratio < 0.5. In azotemic patients, 80 kVp CTA may be accomplished with 100-150 mg I/kg while x-ray tube loading must be increased to maintain the contrast-to-noise ratio at an acceptable level. Peripheral... (More)
The aim of the present paper is to discuss strategies to minimize contrast medium (CM) doses in patients at risk of CM-induced nephropathy (CIN) after computed tomographic angiography (CTA), and percutaneous catheter angiography (PCA) and vascular interventions (PVI). In general a gram-iodine (g-I)/eGFR ratio >= 1.0 appears to be a significant and independent predictor of CIN in CTA and coronary interventions. In high CIN-risk patients (e.g., eGFR < 45 ml/min or multiple risk factors), it is recommended to keep the g-I/eGFR ratio < 0.5. In azotemic patients, 80 kVp CTA may be accomplished with 100-150 mg I/kg while x-ray tube loading must be increased to maintain the contrast-to-noise ratio at an acceptable level. Peripheral PCA/PVI based on digital subtraction technique may be performed with 75-150 mg I/ml, or even lower if the equipment permits manual setting of the x-ray tube potential. Coronary arteriography/interventions may be achieved with 140-150 mg I/ml, i.e., less than half the routinely used concentrations (similar to 320-370 mg I/ml), especially in thinner patients with increased iodine attenuation due to automatic down regulation of the x-ray tube potential. The English full-text version of this article is available at SpringerLink (under "Supplemental"). (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Angiography, Acute kidney injury, Computed tomography, Contrast media, Renal insufficiency
in
Gefässchirurgie
volume
16
issue
7
pages
469 - 469
publisher
Springer
external identifiers
  • wos:000296788800004
  • scopus:84855663056
ISSN
1434-3932
DOI
10.1007/s00772-011-0927-x
language
German
LU publication?
yes
id
a0d4599f-0f2f-4323-879f-5f0c0f1f34e6 (old id 2253327)
date added to LUP
2012-01-02 08:00:00
date last changed
2017-01-01 04:07:25
@article{a0d4599f-0f2f-4323-879f-5f0c0f1f34e6,
  abstract     = {The aim of the present paper is to discuss strategies to minimize contrast medium (CM) doses in patients at risk of CM-induced nephropathy (CIN) after computed tomographic angiography (CTA), and percutaneous catheter angiography (PCA) and vascular interventions (PVI). In general a gram-iodine (g-I)/eGFR ratio &gt;= 1.0 appears to be a significant and independent predictor of CIN in CTA and coronary interventions. In high CIN-risk patients (e.g., eGFR &lt; 45 ml/min or multiple risk factors), it is recommended to keep the g-I/eGFR ratio &lt; 0.5. In azotemic patients, 80 kVp CTA may be accomplished with 100-150 mg I/kg while x-ray tube loading must be increased to maintain the contrast-to-noise ratio at an acceptable level. Peripheral PCA/PVI based on digital subtraction technique may be performed with 75-150 mg I/ml, or even lower if the equipment permits manual setting of the x-ray tube potential. Coronary arteriography/interventions may be achieved with 140-150 mg I/ml, i.e., less than half the routinely used concentrations (similar to 320-370 mg I/ml), especially in thinner patients with increased iodine attenuation due to automatic down regulation of the x-ray tube potential. The English full-text version of this article is available at SpringerLink (under "Supplemental").},
  author       = {Nyman, Ulf},
  issn         = {1434-3932},
  keyword      = {Angiography,Acute kidney injury,Computed tomography,Contrast media,Renal insufficiency},
  language     = {ger},
  number       = {7},
  pages        = {469--469},
  publisher    = {Springer},
  series       = {Gefässchirurgie},
  title        = {Minimierung kontrastmittelinduzierter Nephropathien Strategien bei CTA, Katheterangiographie und Interventionen},
  url          = {http://dx.doi.org/10.1007/s00772-011-0927-x},
  volume       = {16},
  year         = {2011},
}