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使用新一代DyeVert Plus系统在冠状动脉和外周手术中减少造影剂用量及进行造影剂减少和实时监测:初步经验

Contrast Minimization With the New-Generation DyeVert Plus System for Contrast Reduction and Real-Time Monitoring During Coronary and Peripheral Procedures: First Experience.

作者信息

Corcione Nicola, Biondi-Zoccai Giuseppe, Ferraro Paolo, Messina Stefano, Maresca Gennaro, Avellino Raffaella, Napolitano Giovanni, Cavarretta Elena, Giordano Arturo

机构信息

Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso della Repubblica 79, 04100 Latina, Italy.

出版信息

J Invasive Cardiol. 2017 Aug;29(8):259-262.

Abstract

BACKGROUND

Several strategies have been envisioned to reduce the risk of contrast-induced nephropathy, but the most modifiable approach for a treating physician is to minimize contrast administration. To date, there is no report on the use of Osprey Medical's new-generation DyeVert Plus system in coronary or peripheral applications. We aimed to appraise the role of the DyeVert Plus system inclusive of contrast reduction and real-time monitoring in a consecutive series of patients undergoing coronary or peripheral invasive procedures.

METHODS

Baseline, procedural, and outcome details for patients undergoing coronary or peripheral invasive procedures were collected from our institutional database. We primarily focused on total and relative amount of contrast saved, as calculated and displayed by the DyeVert Plus system.

RESULTS

The DyeVert Plus system was used in 10 patients. All procedures were successfully completed with adequate and high-quality angioscopic and angiographic images. No adverse events occurred up to discharge in any patients, with the notable exception of 1 case of asymptomatic and uneventful contrast-induced nephropathy. Average contrast volume was 79.9 ± 48.8 mL (95% confidence interval [CI], 53.2 to 109.4), thanks to an absolute saving of 55.8 ± 31.9 mL (95% CI, 39.1 to 76.7; P<.05) and a relative saving of 41.8 ± 7.3% (95% CI, 37.5 to 46.4; P<.05). Comparison of contrast volume estimates between DyeVert Plus vs manual measurements showed a minimal difference of 1.6 ± 1.9 mL (95% CI, 2.9 to 0.5; P<.05).

CONCLUSION

Use of the new-generation DyeVert Plus system inclusive of contrast reduction and real-time monitoring is feasible in both coronary and peripheral applications while significantly reducing contrast volume.

摘要

背景

已经设想了几种策略来降低造影剂肾病的风险,但对于治疗医生来说,最可调整的方法是尽量减少造影剂的使用。迄今为止,尚无关于Osprey Medical新一代DyeVert Plus系统在冠状动脉或外周应用中的使用报告。我们旨在评估DyeVert Plus系统在一系列连续接受冠状动脉或外周侵入性手术的患者中在减少造影剂使用和实时监测方面的作用。

方法

从我们的机构数据库中收集接受冠状动脉或外周侵入性手术患者的基线、手术过程和结果细节。我们主要关注DyeVert Plus系统计算和显示的造影剂节省总量和相对量。

结果

10例患者使用了DyeVert Plus系统。所有手术均成功完成,获得了足够且高质量的血管内镜和血管造影图像。直至出院,所有患者均未发生不良事件,仅有1例无症状且病情平稳的造影剂肾病为例外。平均造影剂用量为79.9±48.8 mL(95%置信区间[CI],53.2至109.4),绝对节省量为55.8±31.9 mL(95%CI,39.1至76.7;P<0.05),相对节省量为41.8±7.3%(95%CI,37.5至46.4;P<0.05)。DyeVert Plus系统与手动测量的造影剂用量估计值比较显示,差异极小,为1.6±1.9 mL(95%CI,2.9至0.5;P<0.05)。

结论

在冠状动脉和外周应用中,使用包括减少造影剂使用和实时监测功能的新一代DyeVert Plus系统是可行的,同时能显著减少造影剂用量。

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