Department of Surgery, Yale School of Medicine, New Haven, CT.
Division of Vascular Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT.
Ann Vasc Surg. 2021 May;73:490-495. doi: 10.1016/j.avsg.2021.01.081. Epub 2021 Feb 5.
Peripheral vascular interventions (PVI) utilize iodinated contrast medium (ICM) to visualize intravascular lesions and guide therapy. The use of ICM carries a risk of postcontrast acute kidney injury (PC-AKI), which is increased in the elderly and in patients with chronic kidney disease (CKD). Furthermore, the risk of PC-AKI increases with the volume of ICM used. This paper reports a 94-year-old patient with CKD stage 4 who presented with chronic limb threatening ischemia. He underwent successful endovascular revascularization using a combination of CO and dilute ICM (total volume = 6.5 mL). The case demonstrates strategies to minimize ICM during PVIs.
外周血管介入治疗（PVI）使用碘造影剂（ICM）来可视化血管内病变并指导治疗。使用 ICM 会增加对比后急性肾损伤（PC-AKI）的风险，这种风险在老年人和慢性肾脏病（CKD）患者中更高。此外，PC-AKI 的风险会随着 ICM 使用量的增加而增加。本文报告了一例 94 岁患有 CKD 4 期的患者，他患有慢性肢体威胁性缺血。他成功地接受了 CO 和稀释 ICM（总量=6.5 毫升）联合的血管内血运重建。该病例展示了在 PVI 期间尽量减少 ICM 使用的策略。
