News | Cath Lab | May 13, 2016

New Device Reduces Radiographic Contrast in Patients At Risk of Developing Acute Kidney Injury

SCAI late-breaking study shows Advert device may help avoid acute kidney injury

Osprey Avert

May 13, 2016 — In the largest study of its kind, a new device has been found to significantly reduce the volume of radiographic iodine-based contrast without decreasing image quality in patients who are at risk of developing acute kidney injury (AKI) after undergoing a coronary angiography or percutaneous coronary intervention (PCI). The device — known as Avert — did not, however, reduce contrast-induced AKI (CI-AKI). 

The AVERT study results were presented as a late-breaking clinical trial at the Society for Cardiovascular Angiography and Interventions (SCAI) 2016 Scientific Sessions. 

CI-AKI is the sudden deterioration in renal function that can occur after the administration of contrast media volume (CMV) — during an interventional cardiac procedure. CI-AKI is associated with increased morbidity and mortality, and affects an estimated 20 to 30 percent of patients, particularly those with diabetes or previous renal impairment. Minimizing CMV in patients at risk of AKI is a critical preventative measure.

“Physicians are extremely careful about the volume of dye they administer to patients; the greater the volume, the more problems a physician can encounter,” said Roxana Mehran, M.D., FSCAI, director of interventional cardiovascular research and clinical trials at the Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, and the study’s lead author.

With the Avert system, the operator can control the volume of contrast used during an interventional procedure. Once the appropriate amount of contrast has been injected into the coronary, the remaining dye goes into a reservoir, rather than into the aorta.

The prospective, randomized multi-center study enrolled 578 patients, at 39 sites, who were considered to be at risk of CI-AKI while undergoing coronary angiography with or without PCI. The treatment group (n=292) included hydration and Avert; the control group (n=286) received hydration only. The study’s objectives were to assess total CMV used and determine the incidence of CI-AKI, which was defined as a 0.3 mg/dl increase in serum creatinine within 72 hours post-procedure.

Of the 568 patients with CI-AKI, PCI was performed on 239 (42.2 percent). The use of Avert resulted in a 15.5 percent relative reduction in CMV in all patients (86 ± 51 ml vs. 101 ± 71 ml, p=0.002) and a 22.8 percent relative reduction in CMV for PCI patients (114 ml ± 55 vs. 147 ± 81 ml, p=0.001). There were no significant differences in CI-AKI (27 percent vs. 26.2 percent, p=0.72) or adverse event rates between the two groups.

“The bottom line is the Avert system is safe, easy to use and reduces contrast media volume without sacrificing image quality,” Mehran said. “While the use of this device did not result in a significant reduction of CI-AKI, there was one exception. A post-hoc analysis showed that in certain groups — patients with a GFR between 40-60 — CI-AKI was significantly reduced. The next step would be to study patients with moderate chronic kidney disease in a prospective randomized trial.”

Mehran reported a research grant from Osprey Medical for this study.

For more information: www. SCAI.org/SCAI2016 

Related Content

Canon Medical Launches Alphenix Encore Plus Program
News | Angiography | October 09, 2019
In the complex and fast-paced world of healthcare, customers face the challenge of staying up-to-date with the most...
The Artis icono biplane angiography system is designed for use in neurointerventions and interventional radiology

The Artis icono biplane angiography system is designed for use in neurointerventions and interventional radiology. Image courtesy of Siemens Healthineers.

Technology | Angiography | September 17, 2019
The U.S. Food and Drug Administration (FDA) has cleared the Artis icono, a high-precision family of angiography systems...
Jackson Memorial Hospital Holds Ribbon-cutting for New Cardiac Catheterization Labs
News | Angiography | August 21, 2019
Jackson Memorial Hospital in Miami celebrated the opening of two newly renovated cardiac catheterization suites during...
Mentice and Siemens Healthineers Integrate VIST Virtual Patient With Artis Icono Angiography System
Technology | Angiography | June 24, 2019
Siemens Healthineers and Mentice AB announced the collaboration to fully integrate Mentice’s VIST Virtual Patient into...
Medis QAngio XA 3D Receives FDA 510k Clearance
Technology | Angiography | June 04, 2019
Medis Medical Imaging Systems B.V. has received clearance from the U.S. Food and Drug Administration for its QAangio XA...
iSchemaView Launches RAPID Angio
Technology | Angiography | March 01, 2019
iSchemaView announced the release of RAPID Angio, a complete neuroimaging solution for the angiography suite that...
Videos | Angiography | February 08, 2019
This is an example of an arterial venous malformation (AVM) in the brain imaged on a ...
Canon Medical Debuts Alphenix 4-D CT at RSNA 2018
Technology | Angiography | February 06, 2019
Canon Medical Systems USA Inc. recently introduced a new angiography configuration featuring its Alphenix Sky + C-arm...
Canon Medical Systems Launches Alphenix Interventional Imaging Line
Technology | Angiography | February 04, 2019
Canon Medical Systems USA recently introduced its next generation of interventional systems – the Alphenix platform....
An example of multimodality image fusion with live angiography to enhance soft-tissue visualization during complex procedures. This example is from Siemen's new TrueFusion software released in 2018. Advances in angiography imaging.

An example of multimodality image fusion with live angiography to enhance soft-tissue visualization during complex procedures. This example is from Siemen's new TrueFusion software released in 2018. 

Feature | Angiography | January 28, 2019 | Dave Fornell, Editor
There are a few recent trends in X-ray...
Overlay Init