COMPARATIVE EVALUATION OF CARBON DIOXIDE GAS AND lOROMIDE AS CONTRAST AGENTS FOR NON - SELECTIVE INTRA - ARTERIAL DIGITAL SUBTRACTION ANGIOGRAPHY OF KIDNEYS IN DOGS
Loading...
Date
2005
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
AAU, Anand
Abstract
An experiment was conducted on non-selective renal angiography using carbon dioxide gas (CO2) (Group I, n=12) and iopromide (Group II, n =5) as contrast agents by digital subtraction technique in 17 clinically healthy dogs of either sex. The angiographic procedure was carried out under general anaesthetic combination of ketamine (10 mg/kg bodyweight, i.v.) and diazepam (0.5 mg/kg body weight, i.v.) with prior sedation with acepromazine @ 0.05 mg/kg body weight, i.m. The non-selective renal angiography was perfomied by routine catheter introduced Seldinger technique. Later on the aortographic flush in group I was brought by intra-artcrial injection of 80-100 ml of carbon dioxide gas using C02Angioset and that in group II by iopromide @ 2 ml/kg body weight as rapid bolus @ 15 ml/sec. using metal injector. Pre-angiographic, immediate post-angiographic and 48 hrs. post-angiographic arterial blood and urine samples were obtained from animals of either group for biochemical study and urinanalysis. Clinical observations and aortographic image quality was recorded following angiography in both the groups. Under post-angiographic clinical observation, general health, appetite, water intake and urination were found normal with post-angiographic haematoma observed upto 48 hrs. of angiography in all 17 animals. The anaesthetic protocol was found safe with smooth induction and uncomplicated recovery. The aortographic images acquired by CO2 in group I did not reveal good opacification score where satisfactory opacification of the renal vasculature was obtained up to primary (dorsal and ventral) and inter-lobar branches along with renal arteries and aorta. The arcuate ones were noticed in only one animal out of 12 while the inter-lobular branches, capillary phase and nephrogram were found absent. In group II, aortographic images produced by iopromide recorded good opacification score of the renal vascular system, with optimum visualization upto interlobular branches. The capillary phase and nephrogram were also produced. The biochemical study with arterial blood sample revealed a nonsignificant alterations in the determinants of glomerular filtration rate such as blood urea nitrogen and plasma creatinine and also in arterial blood gases like blood pH, partial pressure of oxygen and carbon dioxide, total carbon dioxide and haemoglobin oxygen saturation percentage in either groups after angiography. The plasma electrolytes such as sodium and chloride in group II and potassium in group I revealed a significant decrease and increase at 48 hrs. post-angiography, respectively. The urinanaiysis in both the groups recorded non-significant variations in urine pH and specific gravity, urine creatinine, urinary sodium and protein as well as in urine protein/urine creatinine ratio and urinary fractional excretion of sodium after- angiography. A significant increase in enzymuria like urinary N-acetyl-beta-DGlucosaminidase in either groups and urinary alanine aminopeptidase in group II was observed at immediate post and 48 hrs. post-angiography. Urinary gamma glutamyltransferase non-significantly increased at post-angiography in either groups followed by a non-significant decrease observed in group I at 48 hrs. post-angiography. The present study concludes that under non-selective intra-arterial digital subtraction angiography, delineation of renal vascular anatomy is better with iopromide than CO2. However,C02 still gives adequate delineation of vascular anatomy and inflicts less renal injury than iopromide, hence useful especially in dogs with high risk for renal failure.
Description
Keywords
VETERINARY SURGERY, EVALUATION