A novel contrast removal system from the coronary sinus using an adsorbing column during coronary angiography in a porcine model.

OBJECTIVES This study examined the efficacy of a novel system to remove contrast from the coronary sinus (CS) using an adsorbing column during coronary angiography. BACKGROUND Contrast-induced nephropathy (CIN) has become a serious problem for patients with pre-existing renal insufficiency undergoing percutaneous coronary intervention (PCI). METHODS Eight swine were studied to evaluate the efficacy of the contrast removal system. A newly developed 8-F blood suction catheter was inserted into the CS via the right femoral vein. The venous blood from the CS was transferred into the 500-ml contrast-adsorbing column using an extracorporeal system. A total of 155 ml of contrast medium was infused selectively into the coronary artery. Five swine were treated extracorporeally for 90 min using adsorbing columns, and three were treated without columns as a control group. RESULTS The mean calculated iodine removal rate was 49.4%. The area under the curve of the iodine concentration in the group treated with the column was significantly smaller, by 60%, than that of the group treated without the column (p = 0.0003). No significant adverse effects were observed in the subjects' vital signs throughout the experiments. CONCLUSIONS The contrast removal system from CS is effective and safe during coronary angiography in swine. This technique may be useful for preventing CIN in patients with renal insufficiency undergoing PCI.