Carbon dioxide coronary angiography: A mechanical feasibility study with a cardiovascular simulator
| Autor: | Ivan Corazza, Filippo Scalise, Romano Zannoli, Edoardo Pirazzini, Nevio Taglieri, Pier Luca Rossi, Alessandro Lombi, James G. Caridi |
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| Přispěvatelé: | Corazza, Ivan, Taglieri, Nevio, Pirazzini, Edoardo, Rossi, Pier Luca, Lombi, Alessandro, Scalise, Filippo, Caridi, James G., Zannoli, Romano |
| Rok vydání: | 2018 |
| Předmět: |
Coronary angiography
medicine.medical_specialty Diastole General Physics and Astronomy 030204 cardiovascular system & hematology 030218 nuclear medicine & medical imaging 03 medical and health sciences Coronary circulation 0302 clinical medicine Internal medicine medicine.artery medicine Angiocardiography Aorta medicine.diagnostic_test business.industry lcsh:QC1-999 CO2 angiography coronary arteries contrast-induced nephropathies cerebral ischemia Coronary arteries Catheter medicine.anatomical_structure Angiography cardiovascular system Cardiology business lcsh:Physics |
| Zdroj: | AIP Advances, Vol 8, Iss 1, Pp 015225-015225-11 (2018) |
| ISSN: | 2158-3226 |
| DOI: | 10.1063/1.5016601 |
| Popis: | The aim of this study was to carry out a bench evaluation of the biomechanical feasibility of carbon dioxide (CO2) coronary arteriography. Many patients among the aging population of individuals requiring cardiac intervention have underlying renal insufficiency making them susceptible to contrast-induced nephropathy. To include those patients, it is imperative to find an alternative and safe technique to perform coronary imaging on cardiac ischemic patients. As CO2 angiography has no renal toxicity, it may be a possible solution offering good imaging with negligible collateral effects. Theoretically, by carefully controlling the gas injection process, new automatic injectors may avoid gas reflux into the aorta and possible cerebral damage. A feasibility study is mandatory. A mechanical mock of the coronary circulation was developed and employed. CO2 was injected into the coronary ostium with 2 catheters (2F and 6F) and optical images of bubbles flowing inside the vessels at different injection pressures were recorded. The gas behavior was then carefully studied for quantitative and qualitative analysis. Video recordings showed that CO2 injection at a precise pressure in the interval between the arterial dicrotic notch and the minimum diastolic value does not result in gas reflow into the aorta. Gas reflow was easier to control with the smaller catheter, but the gas bubbles were smaller with different vascular filling. Our simulation demonstrates that carefully selected injection parameters allow CO2 coronary imaging without any risk of gas reflux into the aorta. |
| Databáze: | OpenAIRE |
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