Strategies to Minimize Iodinated Contrast Volume in Patients with Chronic Kidney Disease Undergoing Peripheral
Shin-Rong Lee1, Alan Dardik2, Cassius Iyad Ochoa Chaar2
1Department of Surgery, Yale School of Medicine, New Haven, CT.
Abstract:
Peripheral vascular interventions (PVI) utilize iodinated contrast medium (ICM) to visualize intravascular lesions and guide therapy. The use of ICM carries a risk of postcontrast acute kidney injury (PC-AKI), which is increased in the elderly and in patients with chronic kidney disease (CKD). Furthermore, the risk of PC-AKI increases with the volume of ICM used. This paper reports a 94-year-old patient with CKD stage 4 who presented with chronic limb threatening ischemia. He underwent successful endovascular revascularization using a combination of CO2 and dilute ICM (total volume = 6.5 mL). The case demonstrates strategies to minimize ICM during PVIs.
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