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Clinical Trial
. 2007 Aug;14(4):520-7.
doi: 10.1177/152660280701400413.

Targeted Renal Therapy and Contrast-Induced Nephropathy During Endovascular Abdominal Aortic Aneurysm Repair: Results of a Feasibility Pilot Trial

Affiliations
Clinical Trial

Targeted Renal Therapy and Contrast-Induced Nephropathy During Endovascular Abdominal Aortic Aneurysm Repair: Results of a Feasibility Pilot Trial

David E Allie et al. J Endovasc Ther. .

Abstract

Purpose: To evaluate the feasibility of targeted renal therapy (TRT) to decrease the rate of contrast-induced nephropathy (CIN) during endovascular aortic aneurysm repair (EVAR) in patients at risk for CIN.

Methods: A prospective nonrandomized analysis of TRT was performed in 10 high-risk patients (8 men; median age 66.5 years, range 56-80) with pre-existing renal insufficiency. TRT involved high-dose intrarenal artery infusions of fenoldopam (FEN), a short acting selective dopamine-1 agonist and renal arteriolar vasodilator, delivered percutaneously via a left brachial access using the 5-F Benephit PV Infusion System during EVAR.

Results: There were no device-related complications. TRT infusion duration ranged from 3.5 to 6.0 hours (median 4.5). Median contrast dosage was 120 mL (range 50-200). At 24 and 72 hours after EVAR, creatinine clearance (CrCl) had improved in 7 (70%) patients, remained unchanged in 2 (20%), and declined >25% in 1 (10%); the latter returned to baseline on day 5. At 30 days, 7 (70%) patients had improved CrCl and 3 (30%) remained unchanged.

Conclusion: TRT is feasible during EVAR in high-risk patients. Further investigation is warranted to determine the safety and efficacy of TRT in preserving renal function during EVAR.

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