Dr. Richard Solomon, Chief of Nephrology in the Department of Medicine at the University of Vermont College of Medicine and Fletcher Allen Health Care, introduces causes of Contrast-Induced Nephropathy (CIN) in the catheterization lab and its impact on patient outcomes. He became involved with contrast-induced nephropathy (CIN) from a research perspective in the early 1990s, when he designed and conducted the first prospective randomized trial evaluating different therapies for prevention of CIN. CIN, an acute kidney injury resulting from exposure to radiopaque contrast agents during catheterization, possesses long-term risks of systemic adverse events for affected patients. Moreover, CIN bears a significant economic burden. This comes with higher immediate costs stemming from extended hospital stays, intensified patient care, and increased long-term financial responsibilities associated with managing future adverse events. Dr. Solomon outlines the prerequisites for CIN prevention and presents diverse strategies to mitigate its occurrence. Notably, one key aspect in reducing the risk of CIN lies in optimizing contrast delivery. The ACIST CVi® Contrast Delivery System enables precise control over contrast volume and flow rate, surpassing the capabilities of manual hand injectors. This precise control potentially leads to shorter procedures, decreased contrast administration, and the possibility of earlier post-procedural hydration. For further insights into CIN reduction, prevention strategies, and how ACIST CVi® can play a pivotal role in mitigating CIN for patients through optimal contrast delivery, read on.
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Background:
Contrast-sparing devices have been slowly adopted into routine patient care. Randomized trial evidence of automated contrast injectors (ACIs) has not been analyzed to evaluate the true reduction in contrast volume during coronary angiography and intervention. It has been thought that reducing the amount of contrast exposure will result in a simultaneous reduction in the risk of contrast-induced nephropathy (CIN). Therefore, we sought to synthesize published evidence on contrast-sparing devices, contrast volume, and the incidence of CIN. We searched Medline, the Cochrane Library, and Clinicaltrials.gov. The search criteria included ACIs versus manual injection, contrast media volume, and the incidence of CIN. Data were extracted by 2 independent reviewers. The weighted mean difference of contrast volume was calculated using random effects models in RevMan, version 5.4.1, software to derive a summary estimate. A total of 79,694 patients from 10 studies were included (ACI arm, n [ 20,099; manual injection arm, n [ 59,595). On average, ACIs reduced contrast volume delivery by 45 ml/case (p (p <0.001, 95% confidence interval L54 to L35). The CIN incidence was significantly reduced by 15%, with an odds ratio of 0.85 (p <0.001, 95% confidence interval 0.78 to 0.93) for those using ACIs compared with manual injection. In conclusion, the use of ACIs in angiography significantly reduces the volume of contrast delivered to the patient and the incidence of CIN.
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The ACIST CVi® Contrast Delivery System looks to advance cardiovascular angiographic imaging by providing standardized performance across procedures, whether it involves administering small coronary injections or large volumes in the ventricles and peripheral vasculature. Compared to manual injection methods, the CVi® system ensures consistent contrast delivery, leading to reduced contrast dosage and a notable 15% decrease in contrast-induced nephropathy (CIN) incidence. Not only does this system enhance patient safety, but it also offers precise control over contrast injections. Thus, it caters to the needs of both interventional and diagnostic angiographic procedures. The AngioTouch® hand controller minimizes the requirement for additional imaging and reduces radiation exposure. Overall, the CVi® system simplifies the process while eliminating the strain associated with manual injections, benefiting physicians and staff alike. To explore further details about the ACIST CVi® Contrast Delivery System, including its advantages and product/technical specifications, read on.
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This document focuses on contemporary measures, including automated contrast injection (ACI) systems, to prevent contrast-induced nephropathy (CIN) following catheterization and percutaneous coronary intervention (PCI). The use of automated contrast injection systems, such as the ACIST CVi® Contrast Delivery System, can effectively decrease the volume of contrast used during procedures. It remains uncertain whether lower contrast volume is associated with a reduced incidence of CIN; however, a trial was conducted at Wake Forest University Medical Center involving 1,798 patients who underwent diagnostic catheterization or PCI using handheld manifold injection systems, followed by 377 subsequent patients utilizing an automated contrast injection system. The study’s findings demonstrate that when combined with contemporary hydration and pharmacologic strategies, the use of an automated contrast injection system significantly reduces both contrast volume and the incidence of CIN. For further details on ACIs, such as CVi®, and their positive impact on mitigating contrast-induced nephropathy, continue reading.
Study Objectives: To evaluate the incidence of contrast-induced nephropathy (CIN) with the use of an automated contrast injection system in conjunction with contemporary measures to prevent CIN after cardiac catheterization and percutaneous coronary intervention (PCI).
Background: The use of automated contrast injection systems can reduce the volume of procedural contrast, but whether lower contrast volume is associated with lower incidence of CIN is uncertain
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Join a conversation with Dr. Bob Wilson, founder of ACIST Medical Systems, about the ACIST CVi® Contrast Delivery System. ACIST CVi® System is an automated, variable-rate contrast injection system for angiographic procedures. Some key features of the CVi® mentioned are the variable rate injection controlled by the handheld AngioTouch®, 4 active safety sensors, peristaltic pump for saline delivery, and integrated hemodynamic monitoring from the catheter. Dr. Wilson mentions how CVi® uses pressure to achieve the desired flow rate selected, and how the limit can be set by the operator on the CVi® monitor. Pressure works closely with flow rate, which is the volume of fluid delivered in a specified amount of time. Read on to learn more about ACIST CVi® Contrast Delivery System and valuable insights regarding flow rate parameters and pressure.
Background of Bob Wilson, MD:
Clinical Chief, Cardiovascular Division, University of Minnesota, Dr. Bob Wilson has spent decades focusing on the development of medical, devices for the diagnosis and treatment of cardiovascular diseases. His research into methods for studying the coronary circulation in humans led to the development of the first coronary Doppler catheter to measure coronary blood flow, one among many contributions to science and biomedical engineering projects. He was Founder and Chairman of the Board of Directors of ACIST Medical systems, which now markets a range of devices in 44 countries worldwide.
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The deliberate design of the ACIST CVi® Contrast Delivery System aims to minimize patient risks. With a robust design, the ACIST CVi® has successfully facilitated the diagnosis and treatment of over 30 million coronary procedures while effectively reducing angiographic risks. One key aspect of the CVi® system’s value lies in its ability to reduce contrast volume for patients through various means, including parameter adjustments, real-time dose tracking, variable rate injection, and the utilization of smaller catheters. Moreover, the CVi® System incorporates twelve specific design elements that effectively mitigate the risk of air injection during angiography. Additionally, the CVi® system significantly reduces the occurrence of dissections during procedures, with less than one in a million patients experiencing coronary dissection when using the CVi® system.
Statistics:
The CVi® System can reduce contrast volume for all patients requiring a diagnostic or interventional angiography, resulting in up to 30% reduction in CI-AKI vs. manual injection. The CVi® System has twelve design elements that mitigate air injection. Fewer than 1 in a million patients experience a coronary dissection using the CVi® System.
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