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Published: 2015-07-05

Intraarterial CT Angiography Using Ultra Low Volume of Iodine Contrast – Own Experiences

Jerzy Garcarek, Jacek Kurcz, Maciej Guziński, Mirosław Banasik, Marcin Miś, Tomasz Gołębiowski

(Department of General Radiology, Interventional Radiology ang Neuroradiology, Wrocław Medical University, Wrocław, Poland)

Pol J Radiol 2015; 80:344-349

DOI: 10.12659/PJR.894050

BACKGROUND: High volume of intravenous contrast in CT-angiography may result in contrast-induced nephropathy. Intraarterial ultra-low volume of contrast medium results in its satisfactory blood concentration with potentially good image quality. The first main purpose was to assess the influence of the method on function of transplanted kidney in patients with impaired graft function. The second main purpose of the study was to evaluate the usefulness of this method for detection of gastrointestinal and head-and-neck haemorrhages.
MATERIAL AND METHODS: Between 2010 and 2013 intraarterial CT-angiography was performed in 56 patients, including 28 with chronic kidney disease (CKD). There were three main subgroups: 18 patients after kidney transplantation, 10 patients with gastrointestinal hemorrhage, 8 patients with head-and-neck hemorrhage. Contralateral or ipsilateral inguinal arterial approach was performed. The 4-French vascular sheaths and 4F-catheters were introduced under fluoroscopy. Intraarterial CT was performed using 64-slice scanner. The scanning protocol was as follows: slice thickness 0.625 mm, pitch 1.3, gantry rotation 0.6 sec., scanning delay 1–2 sec. The extent of the study was established on the basis of scout image. In patients with CKD 6–8 mL of Iodixanol (320 mg/mL) diluted with saline to 18–24 mL was administered at a speed of 4–5 mL/s.
RESULTS: Vasculature was properly visualized in all patients. In patients with impaired renal function creatinine/eGFR levels remained stable in all but one case. Traditional arteriography failed and CT-angiography demonstrated the site of bleeding in 3 of 10 patients with symptoms of ga... read more

Keywords: Angiography, Digital Subtraction, Contrast Media, Gastrointestinal Hemorrhage, Infusions, Intra-Arterial, Kidney Transplantation, multidetector computed tomography

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