Lowering iodinated contrast concentration in infrainguinal endovascular interventions: a three-armed randomized controlled non-inferiority trial.
Eur Radiol
; 26(8): 2446-54, 2016 Aug.
Article
en En
| MEDLINE
| ID: mdl-26630997
ABSTRACT
OBJECTIVES:
To determine the influence of lowering iodinated contrast concentration on confidence of interventional radiologists in diagnosing and treating lesions during endovascular interventions in patients with symptomatic peripheral arterial disease (PAD).METHODS:
A randomized controlled non-inferiority trial was performed in 60 patients. Intervention was performed with contrast concentrations (in mg of iodine per mL, mgI/mL) of 300 (standard), 240, or 140 mgI/mL. Primary outcome was confidence (score 0-100 %) of radiologists in diagnosing and treating arterial lesions. Secondary outcomes were procedural iodine load and image quality (i.e. non-diagnostic, limited, diagnostic, exemplary).RESULTS:
Median confidence scores in diagnosing lesions were 100 % (range 81-100 %) for the 300 group (n = 21), 100 % (range 82-100 %) for the 240 group (n = 19), and 100 % (range 91-100 %) for the 140 group (n = 20) (both p = 1.00 compared to the 300 group). Median scores for treating lesions in the 240 and 140 groups, 100 % (range 79-100 %, p = 0.40), and 100 % (range 63-100 %, p = 0.25), respectively, were not lower compared to the 300 group (median 100 %, range 78-100 %). Procedural iodine load was lower in the 240 (24.3 ± 7.6 g, p = 0.022) and 140 groups (17.8 ± 5.6 g, p < 0.001) compared to the 300 group (29.7 ± 6.3 g). Image quality was diagnostic for all groups.CONCLUSION:
Using iodine contrast of 140 mgI/mL for diagnosis and interventions in PAD patients significantly reduces administered iodine load without compromising image quality. Future use of lower iodine dose is recommended. KEY POINTS ⢠Lower iodinated contrast concentration during endovascular intervention does not decrease radiologist's confidence. ⢠Image quality of standardized angiographies remains diagnostic using 140 mgI/mL iodinated contrast concentration. ⢠Iodine load during intervention can be decreased by >40 % when using 140 mgI/mL. ⢠Implementing the use of a lower iodinated contrast concentration will reduce the costs of the procedure.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Angiografía
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Medios de Contraste
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Enfermedad Arterial Periférica
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Yodo
Tipo de estudio:
Clinical_trials
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Observational_studies
Límite:
Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Eur Radiol
Asunto de la revista:
RADIOLOGIA
Año:
2016
Tipo del documento:
Article
País de afiliación:
Países Bajos