Acesso minimamente invasivo da artéria renal com diferentes tipos de cateteres por radiologia convencional / Minimally invasive approach to renal artery using different types of catheter by conventional radiology

ABSTRACT

Background: Several routes of administration have been used for cell and gene therapy delivery in kidney disease in the last years. Moreover, a more homogenous distribution and a higher response was observed when administered intra-arterially. The main objective of the present study was to describe and to compare the use of Fogarty thru-lumen embolectomy catheter with angiographic catheter through the femoral artery by using conventional radiology as a guide.Materials, Methods & Results: Seven healthy dogs were used in these experiments. First, a Fogarty thru-lumen embolectomy catheter was introduced followed by an angiographic catheter. The primary outcome was the number of attempts for the placement of the introducer and the number of radiographic studies to carry out nephrography. Preceding the surgical procedure, ultrasonographic evaluation was performed in all animals in order to measure the diameter of the left and right femoral arteries, left and right renal and abdominal aorta at the renal level. After trichotomy and antisepsis of the medial face of the two pelvic limbs, the 6F valve introducer was placed based on the modified Seldinger technique. Thereafter, aortography was performed, showing its collateral arteries, with contrast injection, and it was estimated how much of the Fogarty 5,5F catheter had to be introduced. Subsequently, a guidewire was inserted through the catheter followed by the Fogarty catheter. Another x-ray was taken to show the position of the catheter. It was observed whether the catheter was positioned correctly and the cuff was filled, and then another contrasting radiograph was performed. If the contrast was not going to the kidneys, the cuff of the catheter was deflated, the catheter was repositioned and a new contrast radiography was performed.[...]