Afshar Arash Ehteshami, Parikh Puja B
Division of Cardiovascular Medicine, Department of Medicine, State University of New York at Stony Brook, Stony Brook, NY, 11794, USA.
Curr Treat Options Cardiovasc Med. 2018 Mar 22;20(4):32. doi: 10.1007/s11936-018-0621-3.
In this review, we provide a summary of the recently published literature on various methods of preventing contrast-induced acute kidney injury (CI-AKI) and radiation-related injuries associated with cardiac catheterization and percutaneous coronary intervention (PCI).
The overall reported incidence of CI-AKI is declining, primarily due to adaptation of a standardized definition for CI-AKI as well as implementation of pre-procedural protocols to prevent or decrease the risk of CI-AKI. The implementation of increasing awareness and establishing radiation protection culture has been shown to be effective measures in reducing radiation exposure. Coronary angiography and PCI are valuable diagnostic and therapeutic tools in cardiovascular medicine. Accurate imaging of the coronary arteries in cardiac catheterization is dependent on the use of intravascular injection of iodinated contrast media and fluoroscopic imaging. Patients undergoing diagnostic and interventional cardiac catheterization may be exposed to a substantial amount of contrast media and ionizing radiation. Administration of contrast media is correlated with increased risk of CI-AKI, and exposure to radiation is known to be associated with a spectrum of acute and chronic tissue injuries.
在本综述中，我们总结了近期发表的关于预防对比剂诱导的急性肾损伤（CI-AKI）以及与心脏导管插入术和经皮冠状动脉介入治疗（PCI）相关的辐射损伤的各种方法的文献。
CI-AKI的总体报告发病率正在下降，这主要归因于对CI-AKI采用了标准化定义以及实施了术前方案以预防或降低CI-AKI的风险。提高认识和建立辐射防护文化已被证明是减少辐射暴露的有效措施。冠状动脉造影和PCI是心血管医学中宝贵的诊断和治疗工具。心脏导管插入术中冠状动脉的精确成像依赖于血管内注射碘化造影剂和荧光透视成像。接受诊断性和介入性心脏导管插入术的患者可能会接触大量造影剂和电离辐射。造影剂的使用与CI-AKI风险增加相关，并且已知辐射暴露与一系列急性和慢性组织损伤有关。
