Coronary venous capture of contrast during angiography

Contrast-induced nephropathy (CIN) after angiographic procedures results in significant morbidity, mortality, and costs. Given the limitations of current prophylactic measures, we have tested the hypothesis that the majority of the contrast injected into a coronary artery can be captured from the coronary sinus before it enters the systemic circulation. The current study involves coronary venous capture after coronary angiography in dogs with determination of contrast capture using quantitative fluoroscopy. Venous contrast capture (VCC) was achieved with a balloon tipped through lumen catheter introduced into the coronary sinus via the superior vena cava. After selective injection of iohexol contrast into the left main coronary artery, the coronary sinus was balloon occluded in order to capture all contrast. The venous blood was subsequently withdrawn from the coronary sinus catheter, and then the balloon was deflated. By quantitative fluoroscopy we could demonstrate that an average 70 ± 6% of the injected contrast could be captured without complications. Coronary sinus VCC is a novel approach to remove the majority of contrast selectively injected into coronary arteries. As an adjunct procedure in coronary angiography, VCC has the potential to significantly reduce the risk of CIN in patients at risk.