Safety of limited supplemental iodinated contrast administration in azotemic patients undergoing CO2 angiography.
OBJECTIVE
To determine if limited doses of iodinated contrast significantly worsen the underlying renal insufficiency that had warranted the use of CO(2) for diagnostic angiography.


METHODS
The records of 122 consecutive patients who had undergone CO(2) angiography for peripheral vascular disease at our institution over a 5-year period were reviewed. The volume and type of iodinated contrast and the volume of CO(2) administered were recorded. Serum creatinine measurements obtained before angiography and from 2 to 3 days after angiography were recorded.


RESULTS
One hundred patients had pre-angiography and post-angiography creatinine levels available for analysis (51 CO(2) only, 49 CO(2) with iodinated contrast). The average pretreatment creatinine level was 2.8+/-1.5 mg/dL (range 1.8-6.6) for the CO(2) only group and 3.0+/-1.4 mg/dL (range 1.8-8.2) for the CO(2) plus iodinated contrast group (p=0.46). After angiography, the mean change in creatinine was +0.17+/-0.87 mg/dL for the CO(2) only group and +0.03+/-0.98 mg/dL in the CO(2) plus contrast group (p=0.27). Complications included 1 patient with a failing renal transplant who received iodinated contrast and ultimately required return to hemodialysis. A second patient had a transient 1-mg/dL rise of creatinine but did not require dialysis.


CONCLUSIONS
This study supports the relative safety of CO(2) angiography with the limited used of iodinated contrast supplementation for diagnostic studies or interventions in azotemic patients with peripheral vascular disease.
Dowling
Kyran
K
Vascular Institute for Health and Disease, Albany Medical Center, Albany, New York 12208, USA. dowlink@mail.amc.edu
Kan
Herman
H
Siskin
Gary
G
Stainken
Brian
B
Ahn
Jiyong
J
Herr
Allen
A
Clement Darling
R
R
D000792:Angiography / Q000009:adverse effects*; D002245:Carbon Dioxide; D003287:Contrast Media / Q000008:administration & dosage* / Q000009:adverse effects; D003404:Creatinine / Q000097:blood; D006801:Humans; D007455:Iodine / Q000008:administration & dosage* / Q000009:adverse effects; D016491:Peripheral Vascular Diseases / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D014511:Uremia / Q000097:blood / Q000150:complications*
D003287:Contrast Media; D002245:Carbon Dioxide; D007455:Iodine; D003404:Creatinine