| Title | A Novel Technique for Endovascular Detection and Removal of Radiographic Contrast during Angiography. | | Author(s) | Chang H, Hassan AH, Kim YL, Lloyd LJ, Koo BK, Ako J, Honda Y, Davidson CJ, Fitzgerald PJ | | Institution | Center for Cardiovascular Technology, Stanford University Medical Center, 300 Pasteur Drive, Room H3554, Stanford, CA, 94305, USA. crci-cvmed@stanford.edu. | | Source | J Invasive Cardiol 2009 Jul; 21(7):314-8. | | Abstract | OBJECTIVES: This study aims at in-vitro validation of the principles of endovascular detection of contrast medium and assessing the feasibility of in-vivo detection and removal of contrast during angiography.
BACKGROUND: Contrast-induced nephropathy is a growing concern in current percutaneous interventions with increasing lesion complexity and patient comorbidity. To address this clinical problem, a novel method of endovascular detection and automatic removal of contrast has been developed, and is comprised of a catheter-based system with a reflectance-type optical sensor.
METHODS: Blood samples were obtained from ovine subjects to characterize the optical response of blood by measuring the reflectance spectrum at varying levels of hematocrit diluted by a contrast agent. The results from the in-vitro test were implemented into an in-vivo system. An aspiration catheter equipped with a fiberoptic sensor was inserted into the coronary sinus (CS) of 5 canines. Contrast was administered through the coronary artery and reflectance signals were recorded at the CS. The removal rate was analyzed through 20 specimen collections.
RESULTS: A proportional relationship was found between hematocrit and reflectance intensity in in-vitro test. Upon in-vivo detection of contrast, the sensor signal showed a 79.5 +/- 9.9% (n = 33) drop from the pre-injection baseline. This was highly reproducible and beyond the noise level of baseline, (2.5 +/- 0.9%), enabling automatic activation of the aspiration system. The signal duration was 12.2 +/- 3.7 seconds. The removal rate of contrast was 59.3 +/- 11%.
CONCLUSION: The present study validated the principles of endovascular contrast detection and demonstrated the feasibility of an in-vivo, catheter-based removal of contrast using reflectance technology. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 19571339 |
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