دورية أكاديمية
Contrast conservation measures during the global iohexol contrast shortage crisis did not affect stroke thrombectomy outcomes
| العنوان: | Contrast conservation measures during the global iohexol contrast shortage crisis did not affect stroke thrombectomy outcomes |
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| المؤلفون: | Almallouhi, Eyad, Sattur, Mithun, Lajthia, Orgest, Kicielinski, Kimberly P, Holmstedt, Christine, Lena, Jonathan R, Al Kasab, Sami, Spiotta, Alejandro M |
| بيانات النشر: | BMJ Publishing Group Ltd |
| سنة النشر: | 2023 |
| المجموعة: | HighWire Press (Stanford University) |
| مصطلحات موضوعية: | Ischemic stroke |
| الوصف: | Background The current global shortage in iohexol contrast material (Omnipaque) used in performing CT-based triage images and mechanical thrombectomy (MT) represents a challenge to the healthcare system. A study was undertaken to assess the safety and feasibility of implementing protocol-based changes in pre-MT and MT workflow at a comprehensive stroke center. Methods A retrospective cohort study was undertaken of all patients with stroke who underwent MT during a 3-week period before implementing the contrast shortage protocol and for 3 weeks while implementing the protocol. The contrast shortage protocol included not performing perfusion images for MT selection and using diluted iohexol (50% contrast mixed with 50% heparinized saline) during the MT procedure. Procedural variables were compared between the two groups. Results A total of 27 patients underwent MT during the study period, 12 pre-contrast shortage and 15 post-contrast shortage. The average contrast volume used during the MT procedure was reduced from 83 mL to 68 mL after implementing the contrast shortage protocol (p=0.04). No difference was noted in the rate of successful reperfusion (11/15 vs 10/12), average time to recanalization (21 vs 23 min), average radiation dose (1143 vs 1117mGy) and time under fluoroscopy (20.7 vs 20.5 min) in the pre- and post-contrast shortage groups. A favorable discharge outcome was observed in 3/12 patients and 4/15 patients in the pre- and post-shortage periods, respectively (p=0.92). Conclusions Modifying stroke workflow to adapt to the current global shortage in iohexol is feasible. Using diluted iohexol (50% contrast mixed with 50% heparinized saline) did not affect MT outcomes. |
| نوع الوثيقة: | text |
| وصف الملف: | text/html |
| اللغة: | English |
| العلاقة: | http://jnis.bmj.com/cgi/content/short/15/e1/e76Test; http://dx.doi.org/10.1136/jnis-2022-019210Test |
| DOI: | 10.1136/jnis-2022-019210 |
| الإتاحة: | https://doi.org/10.1136/jnis-2022-019210Test http://jnis.bmj.com/cgi/content/short/15/e1/e76Test |
| حقوق: | Copyright (C) 2023, Society of NeuroInterventional Surgery |
| رقم الانضمام: | edsbas.63E7BF10 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1136/jnis-2022-019210 |
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