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A novel contrast removal system from the coronary sinus using an adsorbing column during coronary angiography in a
Ichiro Michishita1, Zenzo Fujii
1Division of Cardiology, Department of Internal Medicine, Yokohama Sakae Kyosai Hospital, Federation of National Public Service Personnel Mutual Aid Associations, Yokohama, Japan. yk411015@fsinet.or.jp
Insights
A novel system effectively removes contrast media from the coronary sinus (CS) during angiography in swine. This extracorporeal contrast removal technique shows promise for preventing contrast-induced nephropathy (CIN) in at-risk patients.
Area of Science:
- Cardiovascular Interventions
- Nephrology
- Biomedical Engineering
Background:
- Contrast-induced nephropathy (CIN) is a significant complication for patients with renal insufficiency undergoing percutaneous coronary intervention (PCI).
- Effective strategies to mitigate CIN risk during contrast-enhanced procedures are crucial.
Purpose of the Study:
- To evaluate the efficacy and safety of a novel system designed to remove contrast media from the coronary sinus (CS) during coronary angiography.
- To assess the potential of this system in preventing CIN in patients with compromised renal function.
Main Methods:
- An extracorporeal system with a contrast-adsorbing column was used to process venous blood from the CS in eight swine.
- Contrast medium was infused into the coronary artery, and contrast removal was assessed over 90 minutes.
- A control group without the adsorbing column was used for comparison.
Main Results:
- The system achieved a mean iodine removal rate of 49.4%.
- The contrast-adsorbing column significantly reduced iodine concentration by 60% compared to the control group (p = 0.0003).
- No significant adverse effects on vital signs were observed during the experiments.
Conclusions:
- The novel contrast removal system is effective and safe for use during coronary angiography in a swine model.
- This technique holds potential as a method to prevent contrast-induced nephropathy in patients with renal insufficiency undergoing PCI.
Objectives:
This study examined the efficacy of a novel system to remove contrast from the coronary sinus (CS) using an adsorbing column during coronary angiography.
Background:
Contrast-induced nephropathy (CIN) has become a serious problem for patients with pre-existing renal insufficiency undergoing percutaneous coronary intervention (PCI).
Methods:
Eight swine were studied to evaluate the efficacy of the contrast removal system. A newly developed 8-F blood suction catheter was inserted into the CS via the right femoral vein. The venous blood from the CS was transferred into the 500-ml contrast-adsorbing column using an extracorporeal system. A total of 155 ml of contrast medium was infused selectively into the coronary artery. Five swine were treated extracorporeally for 90 min using adsorbing columns, and three were treated without columns as a control group.
Results:
The mean calculated iodine removal rate was 49.4%. The area under the curve of the iodine concentration in the group treated with the column was significantly smaller, by 60%, than that of the group treated without the column (p = 0.0003). No significant adverse effects were observed in the subjects' vital signs throughout the experiments.
Conclusions:
The contrast removal system from CS is effective and safe during coronary angiography in swine. This technique may be useful for preventing CIN in patients with renal insufficiency undergoing PCI.
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