Author + information
- Saad Sultan Ghumman,
- Jonathan Weinerman,
- Aazib Khan,
- Mubeen Cheema,
- Dan Levin,
- Rajeev Suri,
- Marlene Garcia and
- Anand Prasad
Background: Contrast-induced nephropathy (CIN) is a known complication following endovascular procedures with iodinated contrast media (ICM). Carbon dioxide (CO2) has been employed as an alternative imaging medium as it is nontoxic to the kidneys. We conducted a meta analysis of available studies to compare the incidence of CIN with CO2 vs ICM.
Methods: Search of indexed databases with keywords “CO2“, “ICM”, “Peripheral Angiography” and “CIN” was performed. 1,732 references were retrieved, 50 included in an initial systematic review, 8 studies formed the meta analysis. Primary outcome studied was CIN. Random effect model was used for analysis. Publication bias was analyzed.
Results: 677 patients underwent 738 peripheral angiographic procedures. Compared with ICM, CO2 was associated with a decreased incidence of CIN (4.3% vs 12.8%; OR 0.465, 95% CI: 0.218-0.992; p= 0.048), Figure 1. Subgroup analysis of 4 studies that included granular data for patients with chronic kidney disease (CKD) did not demonstrate a decreased incidence of CIN with CO2 (4.1% vs 10.0%; OR 0.449, 95% CI: 0.165-1.221, p=0.117). Patients undergoing CO2 angiography experienced a higher number of nonrenal events such as limb/abdominal pain (11 vs 0, p=0.004) and nausea/vomiting (9 vs 1, p=0.002).
Conclusions: In comparison to ICM, CO2 use is associated with a reduced rate of CIN. However, studies which included only CKD patients demonstrated no benefit of CO2 over ICM. CO2 use is also associated with more frequent adverse nonrenal events.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Endovascular Therapy: Running From Risk
Abstract Category: 39. Vascular Medicine: Endovascular Therapy
Presentation Number: 1299-360
- 2017 American College of Cardiology Foundation