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Novel device yields contrast savings during peripheral angiography
New results suggest that a contrast modulation system was associated with significant contrast savings during peripheral angiography without sacrificing image quality.
The system (AVERT, Osprey Medical) features an adjustable resistance circuit that reduces the pressure head delivering contrast to the patient. Researchers aimed to determine contrast savings associated with the system while also assessing its capacity to produce clinically acceptable digital subtraction angiography (DSA) images.
In all, researchers culled 408 DSA sequences from 22 patients (age, 61.8 ± 13.6 years) who underwent 29 procedures. Sixty-eight percent of patients presented with chronic kidney disease, 82% had critical limb ischemia, 18% had claudication, and all patients had diabetes and hypertension.
Data revealed a mean contrast savings of 37% with the system — 31% for diagnostic DSA and 40% for interventional procedures. Ninety-one percent of the images were acceptable for clinical decision making, which was composed of 94% acceptable diagnostic images and 87% acceptable interventional images.
In addition, injection via a 5F catheter was associated with a higher rate of acceptable images compared with injection via a 4F catheter (96% vs. 77%). Furthermore, as the size of sheath injections increased, so too did the image quality: 5F, 86%; 6F, 91%; and 7F, 98%.
In other data, the researchers confirmed the in vivo findings, as the bench model of peripheral angiography displayed a significant reduction in reflux of contrast proximal to the end of the catheter without compromising the antegrade image quality.
The researchers added that the direct role of contrast volume lowering and acute kidney injury outcomes during peripheral procedures needs to be better defined.
“Specifically, the use of the AVERT system to reduce [acute kidney injury] incidence in patients undergoing peripheral angiography warrants study,” they wrote. – by Brian Ellis
Disclosure: Two researchers report consulting for Osprey Medical and one serves on the advisory board of Osprey Medical.