title: A Novel Technique to Reduce Contrast Exposure During Subclavian Interventions.
abstract: We describe a novel technique to minimize total body contrast exposure during endovascular angiography. A patient with severe renal impairment and history of contrast-induced nephropathy was referred for subclavian artery intervention. Angiography and intervention was performed via transfemoral access, while a transradial sheathless-guiding catheter was used to aspirate injected contrast/blood mix from the downstream axillary artery. Semiquantitative analysis indicated approximately 50% of the injected contrast was retrieved. Adaptation of this simple strategy could be considered for selected coronary, lower extremity, and carotid procedures, using contrast removal techniques from the coronary sinus, femoral, and jugular veins.
authors.affiliation: 1 Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA.
authors.forename: Saurabh
authors.initials: S
authors.lastname: Sanon
authors.affiliation: 1 Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA.
authors.forename: Gregory W
authors.initials: GW
authors.lastname: Barsness
authors.affiliation: 1 Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA.
authors.forename: Rajiv
authors.initials: R
authors.lastname: Gulati
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced; D000368:Aged; D015901:Angiography, Digital Subtraction / Q000009:adverse effects; D000800:Angioplasty, Balloon / Q000295:instrumentation; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D003251:Constriction, Pathologic; D003287:Contrast Media / Q000008:administration & dosage* / Q000009:adverse effects; D057505:Embolic Protection Devices; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000175:diagnosis; D012307:Risk Factors; D015607:Stents; D013348:Subclavian Artery / Q000000981:diagnostic imaging; D016896:Treatment Outcome; D014283:Triiodobenzoic Acids / Q000008:administration & dosage* / Q000009:adverse effects; D018084:Ultrasonography, Interventional
chemical_list: D003287:Contrast Media; D014283:Triiodobenzoic Acids; C044834:iodixanol
keywords: contrast minimization; embolic protection; subclavian stent