PMID- 30393942
OWN - NLM
STAT- MEDLINE
DCOM- 20200622
LR  - 20200622
IS  - 1522-726X (Electronic)
IS  - 1522-1946 (Linking)
VI  - 93
IP  - 7
DP  - 2019 Jun 1
TI  - Minimizing radiographic contrast administration during coronary angiography using 
      a novel contrast reduction system: A multicenter observational study of the 
      DyeVert plus contrast reduction system.
PG  - 1228-1235
LID - 10.1002/ccd.27935 [doi]
AB  - OBJECTIVE: To evaluate contrast media (CM) volume (CMV) saved using the DyeVert 
      Plus Contrast Reduction System (DyeVert Plus System, Osprey Medical) in patients 
      undergoing diagnostic coronary angiogram (CAG) and/or percutaneous coronary 
      interventional (PCI) procedures performed with manual injections. BACKGROUND: 
      Current guidelines advocate for monitoring and minimization of the total volume 
      of CM in chronic kidney disease (CKD) patients undergoing invasive cardiac 
      procedures. The DyeVert Plus System is an FDA cleared device designed to reduce 
      CMV delivered during angiography and permit real-time CMV monitoring. METHODS: We 
      performed a multicenter, single-arm, observational study. Eligible subjects 
      were >/= 18 years old with baseline estimated glomerular filtration rate (eGFR) 
      20-60 mL/min/1.73 m(2) . The primary endpoint was % CMV saved over the total 
      procedure. A secondary objective was to evaluate adverse events (AEs) related to 
      DyeVert Plus System or to CM use. RESULTS: A total of 114 subjects were enrolled 
      at eight centers. Mean age was 72 +/- 9 years, 72% were male, and mean body mass 
      index was 29 +/- 5. Baseline eGFR was 43 +/- 11 mL/min/1.73 m(2) . CAG-only was 
      performed in 65% of cases. One hundred and five subjects were evaluable for the 
      primary endpoint. Mean CMV attempted was 112 +/- 85 mL (range 22-681) and mean CMV 
      delivered was 67 +/- 51 mL (range 12-403), resulting in an overall CMV savings of 
      40.1 +/- 8.8% (95% CI 38.4, 41.8; P < 0.0001) per procedure. Image quality was 
      maintained in all but one case where the system was turned off for one injection. 
      No DyeVert Plus System-related AEs were reported. Acute kidney injury (AKI; 
      defined as serum creatinine rise of >0.3 mg/dL from baseline) was reported in 11 
      cases with seven occurring in subjects with baseline eGFR < 30 and three AKI 
      events were attributed to CM. AKI rates increased as CMV/eGFR ratios increased. 
      CONCLUSIONS: These data suggest DyeVert Plus System use in CKD patients 
      undergoing CAG and/or PCI results in clinically meaningful CMV savings while 
      maintaining image quality.
CI  - (c) 2018 Wiley Periodicals, Inc.
FAU - Gurm, Hitinder S
AU  - Gurm HS
AUID- ORCID: 0000-0002-1646-0218
AD  - Department of Medicine, Division of Cardiovascular Medicine, University of 
      Michigan, Ann Arbor, Michigan.
FAU - Mavromatis, Kreton
AU  - Mavromatis K
AD  - Department of Medicine, Cardiology Division, Atlanta VA Medical Center, Emory 
      University School of Medicine, Decatur, Georgia.
FAU - Bertolet, Barry
AU  - Bertolet B
AD  - Cardiology Associates Research, LLC, North Mississippi Medical Center, Tupelo, 
      Mississippi.
FAU - Kereiakes, Dean J
AU  - Kereiakes DJ
AUID- ORCID: 0000-0003-1086-127X
AD  - Christ Hospital, Heart and Vascular Center, Lindner Research Center, Cincinnati, 
      Ohio.
FAU - Amin, Amit P
AU  - Amin AP
AD  - Cardiovascular Division, Washington University School of Medicine, St. Louis, 
      Missouri.
FAU - Shah, Atman P
AU  - Shah AP
AD  - Section of Cardiology, University of Chicago Medical Center, Chicago, Illinois.
FAU - Hanzel, George S
AU  - Hanzel GS
AD  - Department of Medicine, Division of Cardiology, William Beaumont Hospital, Heart 
      and Vascular, Royal Oak, Michigan.
FAU - Rao, Siddhartha
AU  - Rao S
AD  - WakeMed Heart and Vascular, Raleigh, North Carolina.
FAU - Thomas, Joseph L
AU  - Thomas JL
AD  - Division of Cardiology, Harbor-UCLA Medical Center, Torrance, California.
FAU - Kumar, Gautam
AU  - Kumar G
AUID- ORCID: 0000-0002-4284-846X
AD  - Department of Medicine, Cardiology Division, Atlanta VA Medical Center, Emory 
      University School of Medicine, Decatur, Georgia.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
DEP - 20181104
PL  - United States
TA  - Catheter Cardiovasc Interv
JT  - Catheterization and cardiovascular interventions : official journal of the 
      Society for Cardiac Angiography & Interventions
JID - 100884139
RN  - 0 (Contrast Media)
SB  - IM
CIN - Catheter Cardiovasc Interv. 2019 Jun 1;93(7):1236. PMID: 31172680
MH  - Acute Kidney Injury/chemically induced/diagnostic 
      imaging/physiopathology/*prevention & control
MH  - Aged
MH  - Aged, 80 and over
MH  - Contrast Media/*administration & dosage/adverse effects
MH  - Coronary Angiography/adverse effects/*instrumentation
MH  - Coronary Artery Disease/complications/*diagnostic imaging/therapy
MH  - Equipment Design
MH  - Female
MH  - *Glomerular Filtration Rate
MH  - Humans
MH  - Kidney/*drug effects/physiopathology
MH  - Male
MH  - Middle Aged
MH  - Percutaneous Coronary Intervention
MH  - Predictive Value of Tests
MH  - Prospective Studies
MH  - Protective Factors
MH  - Renal Insufficiency, Chronic/complications/diagnosis/physiopathology
MH  - Risk Factors
MH  - Treatment Outcome
MH  - United States
OTO - NOTNLM
OT  - ANCO-angiography
OT  - CONT-contrast agents
OT  - IAF-imaging
OT  - PCI-percutaneous coronary intervention
OT  - RDAC-renal disease-acute
OT  - angiographic/fluoroscopic
OT  - coronary
EDAT- 2018/11/06 06:00
MHDA- 2020/06/23 06:00
CRDT- 2018/11/06 06:00
PHST- 2018/07/16 00:00 [received]
PHST- 2018/08/30 00:00 [revised]
PHST- 2018/09/23 00:00 [accepted]
PHST- 2018/11/06 06:00 [pubmed]
PHST- 2020/06/23 06:00 [medline]
PHST- 2018/11/06 06:00 [entrez]
AID - 10.1002/ccd.27935 [doi]
PST - ppublish
SO  - Catheter Cardiovasc Interv. 2019 Jun 1;93(7):1228-1235. doi: 10.1002/ccd.27935. 
      Epub 2018 Nov 4.