Can Peripheral Angiography Be Safely Performed in Patients with Chronic Renal Insufficiency Without Significant Risk of Contrast-Associated Renal Injury in Outpatient Settings?

Contrast-associated acute kidney injury (CA-AKI) is a known complication following coronary angiographic procedures using iodinated contrast media (ICM). The risk of CA-AKI is multifactorial, dependent largely on estimated glomerular filtration rates. The most important and accepted hospital-based preventive strategy involves both a reduction of iodinated contrast and multi-hour pre- and post-intervention normal saline hydration. Because of time constraints, neither ambulatory surgical centers (ASC), nor outpatient-based laboratories (OBL) can provide similar degrees of pre- and post-intervention hydration. The utilization of carbon dioxide (CO2) imaging, intravascular ultrasonography, and limited iso-osmolar contrast agents may provide an alternative preventive strategy.