Over the past decade, interventional endovascular treatment, whenever feasible, has become the first line management in the treatment of lower extremity arterial disease (LEAD) for many indications. Growth of endovascular therapy was based on shorter hospital length of stay and lower complications rates. This minimally invasive procedure allows the revascularization of the lower limbs under fluoroscopy guidance, with injection of iodinated contrast allowing to analyze the arteries. However, many of these patients present renal insufficiency which could be worsened due to the iodinated contrast injections during the endovascular procedure for LEAD. Consequently, the vascular interventionalist should find a way to achieve patient revascularization while minimizing iodinated contrast injections in order to maintain the renal function. The aim of this study is to compare the amount of iodine contrast used during LEAD endovascular revascularization with and without the Innova Breeze® and blended roadmap software.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
40
An Innova Breeze® bolus chase acquisition is realized to assess the final result of the Revascularization of the target limb. Both Innova Breeze® bolus chases are required at field of view 30-cm
2D roadmap guidance is used based on DSA. The treatment of the target lesion is let at the physician discretion. Treatment result of each lesion is checked by a DSA with 1 incidence. After treatment overall limb assessment will be done through multiple staged DSA. Finally, the sheath is retrieved and the hemostasis at the puncture site is realized via a manual compression or using a vascular closure device. DSAs are performed with the injector set at 7mL/s and the volume at 7mL (pressure limit 1000psi) for femoropopliteal assessment. An injector with iodinated contrast (50% of dilution) will be used. For hospitalized patients, three to five days after the procedure, a blood test is performed to assess the eGFR, as part of the usual care of patients. If the patient is no longer hospitalized, at the time of this examination, the investigating physician has given him an order before his discharge to perform this examination in an analysis laboratory.
Groupe Hospitalier Paris Saint-Joseph
Paris, France
RECRUITINGAmount of iodinated contrast volume
This outcome corresponds to the volume of iodinated contrast used at the end of the procedure.
Time frame: Day 1
Patient safety in terms of radiation exposure at the end of the procedure
This outcome corresponds to the number of DSA runs.
Time frame: Day 1
Staff safety in terms of radiation exposure at the end of the procedure
This outcome corresponds to the Operator exposure (Sv).
Time frame: Day 1
Patient clinical improvement
This outcome corresponds to the clinical status (Rutherford stage).
Time frame: Month 1
Estimation of renal function post-operative
This outcome corresponds to the Glomerular filtration rate (GFR).
Time frame: Day 4
Estimation of renal function at 1 month
This outcome corresponds to the Glomerular filtration rate (GFR)
Time frame: Month 1
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.