TY - JOUR
T1 - A novel technique for endovascular detection and removal of radiographic contrast during angiography
AU - Chang, Hyeonsoo
AU - Hassan, Ali H.M.
AU - Kim, Young L.
AU - Lloyd, Lester J.
AU - Koo, Bon Kwon
AU - Ako, Junya
AU - Honda, Yasuhiro
AU - Davidson, Charles J.
AU - Fitzgerald, Peter J.
PY - 2009/7/1
Y1 - 2009/7/1
N2 - OBJECTIVES: This study aims at in-vitro validation of the principles of endovascular detection of contrast medium and assessing the feasibility of in-vivo detection and removal of contrast during angiography. BACKGROUND: Contrast-induced nephropathy is a growing concern in current percutaneous interventions with increasing lesion complexity and patient comorbidity. To address this clinical problem, a novel method of endovascular detection and automatic removal of contrast has been developed, and is comprised of a catheter-based system with a reflectance-type optical sensor. METHODS: Blood samples were obtained from ovine subjects to characterize the optical response of blood by measuring the reflectance spectrum at varying levels of hematocrit diluted by a contrast agent. The results from the in-vitro test were implemented into an in-vivo system. An aspiration catheter equipped with a fiberoptic sensor was inserted into the coronary sinus (CS) of 5 canines. Contrast was administered through the coronary artery and reflectance signals were recorded at the CS. The removal rate was analyzed through 20 specimen collections. RESULTS: A proportional relationship was found between hematocrit and reflectance intensity in in-vitro test. Upon in-vivo detection of contrast, the sensor signal showed a 79.5 ± 9.9% (n ≤ 33) drop from the pre-injection baseline. This was highly reproducible and beyond the noise level of baseline, (2.5 ± 0.9%), enabling automatic activation of the aspiration system. The signal duration was 12.2 ± 3.7 seconds. The removal rate of contrast was 59.3 ± 11%. CONCLUSION: The present study validated the principles of endovascular contrast detection and demonstrated the feasibility of an in-vivo, catheter-based removal of contrast using reflectance technology.
AB - OBJECTIVES: This study aims at in-vitro validation of the principles of endovascular detection of contrast medium and assessing the feasibility of in-vivo detection and removal of contrast during angiography. BACKGROUND: Contrast-induced nephropathy is a growing concern in current percutaneous interventions with increasing lesion complexity and patient comorbidity. To address this clinical problem, a novel method of endovascular detection and automatic removal of contrast has been developed, and is comprised of a catheter-based system with a reflectance-type optical sensor. METHODS: Blood samples were obtained from ovine subjects to characterize the optical response of blood by measuring the reflectance spectrum at varying levels of hematocrit diluted by a contrast agent. The results from the in-vitro test were implemented into an in-vivo system. An aspiration catheter equipped with a fiberoptic sensor was inserted into the coronary sinus (CS) of 5 canines. Contrast was administered through the coronary artery and reflectance signals were recorded at the CS. The removal rate was analyzed through 20 specimen collections. RESULTS: A proportional relationship was found between hematocrit and reflectance intensity in in-vitro test. Upon in-vivo detection of contrast, the sensor signal showed a 79.5 ± 9.9% (n ≤ 33) drop from the pre-injection baseline. This was highly reproducible and beyond the noise level of baseline, (2.5 ± 0.9%), enabling automatic activation of the aspiration system. The signal duration was 12.2 ± 3.7 seconds. The removal rate of contrast was 59.3 ± 11%. CONCLUSION: The present study validated the principles of endovascular contrast detection and demonstrated the feasibility of an in-vivo, catheter-based removal of contrast using reflectance technology.
KW - Contrast detection
KW - Contrast-induced nephropathy
KW - Intravascular optic sensor
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M3 - Article
C2 - 19571339
AN - SCOPUS:68049096086
VL - 21
SP - 314
EP - 318
JO - Journal of Invasive Cardiology
JF - Journal of Invasive Cardiology
SN - 1042-3931
IS - 7
ER -