title: Ultralow Iodine Dose Transarterial Catheter-Directed CT Angiography for Fenestrated Endovascular Aortic Repair Planning.
abstract: BACKGROUND
  Preoperative planning for fenestrated endovascular aortic repair (fEVAR) requires high-quality cross-sectional imaging, most commonly computed tomography angiography (CTA). However, in the setting of chronic kidney disease (CKD), the iodine load delivered during conventional CTA is associated with risk for acute kidney injury (AKI). In this report, we describe the feasibility of using transarterial catheter directed CT angiography (tcd-CTA) with ultralow-dose iodine as an alternative for fEVAR planning in patients with stage 3-4 CKD to lower the risk of AKI.
  
  
  METHODS
  Preserum and postserum creatinine levels were retrospectively evaluated from 8 patients with stage 3-4 CKD who underwent tcd-CTA with 20 mL of Iohexol for fEVAR planning for the treatment of pararenal abdominal aortic aneurysms. The tcd-CTA images were evaluated by two vascular surgeons for adequacy for fEVAR planning and progression to fEVAR completion was recorded.
  
  
  RESULTS
  The mean serum creatinine before tcd-CTA was 2.1 ± .32 mg/dL, and the mean estimated glomerular filtration rate was 29.7 ± 6.31 mL/min/1.73 m(2). After tcd-CTA, the mean serum creatinine was 1.9 ± .25 mg/dL and the mean estimated glomerular filtration rate was 32.9 ± 5.12 mL/min/1.73 m(2). All 8 of the studies were determined to be adequate for fEVAR planning independently by two vascular surgeons. Six of the patients underwent successful fEVAR and 2 opted for watchful waiting.
  
  
  CONCLUSIONS
  tcd-CTA with ultralow-dose iodine is a feasible option for pre-fEVAR planning in patients with stage 3-4 CKD.
authors.affiliation: Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC. Electronic address: ari_isaacson@med.unc.edu.
authors.forename: Ari J
authors.initials: AJ
authors.lastname: Isaacson
authors.affiliation: Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC.
authors.forename: Lauren M B
authors.initials: LM
authors.lastname: Burke
authors.affiliation: Department of Vascular Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC.
authors.forename: Raghuveer
authors.initials: R
authors.lastname: Vallabhaneni
authors.affiliation: Department of Vascular Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Farber
mesh_terms: D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D001027:Aortography / Q000009:adverse effects / Q000379:methods*; D015415:Biomarkers / Q000097:blood; D002406:Catheterization, Peripheral; D000072226:Computed Tomography Angiography / Q000009:adverse effects; D003287:Contrast Media / Q000008:administration & dosage* / Q000009:adverse effects; D003404:Creatinine / Q000097:blood; D057510:Endovascular Procedures; D005240:Feasibility Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D007269:Injections, Intra-Arterial; D007472:Iohexol / Q000008:administration & dosage* / Q000009:adverse effects; D018579:Patient Selection; D011237:Predictive Value of Tests; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D003287:Contrast Media; D007472:Iohexol; D003404:Creatinine