Digital Variance Angiography for Contrast Media Dose Reduction in Carotid Artery Stenting
Digital Variance Angiography for Contrast Media Dose Reduction in Carotid Artery Stenting
Digital Variance Angiography (DVA) is a new tool in medical imaging with a proven image
 quality reserve (1, 2).

 Previous studies have demonstrated the quality reserve of DVA in angiographic studies (1, 2),
 which allowed us to reduce contrast media use by 50% in carotid artery angiographic studies
 without affecting the image quality (3).

 CAS is an alternative treatment option for carotid artery revascularization in selected
 patient groups. Similar to most of the minimally invasive endovascular interventions, CAS
 also carries the risk of contrast-induced acute kidney injury, which is considered to be an
 independent predictor of 30-day major adverse events (4).

 The aim of this study is to apply DVA in patients undergoing carotid artery stenting (CAS)
 and utilize this technique to reduce contrast dose during the interventions, without
 affecting the intraprocedural radiation dose and the clinical outcome of the procedures.
 Investigators believe that the reduction in contrast media use and the associated image
 quality with the technique of DVA imaging can be incorporated into the everyday clinical
 practice, and will play an important role in improving the rate of contrast-induced acute
 kidney injury.
Inclusion Criteria:

 -  Age > 18 y

 -  Carotid stenosis defined as:

 Stenosis ≥70% by computer tomography angiography (NASCET criteria); OR by duplex-ultrasound
 with ≥70% stenosis defined by a peak systolic velocity of at least 230 cm/s

 -  Carotid stenosis is treatable with CAS

 Exclusion Criteria:

 -  History of stroke or TIA ipsilateral to the stenosis within 30 days of randomization

 -  Acute myocardial infarction

 -  Severe chronic kidney disease: GFR>30ml/min/m2

 -  Severe heart failure: NYHA IV

 -  Severe liver failure: Child-Pugh 3

 -  Iodine contrast allergy

 -  Coagulopathy

 -  Hematological bleeding disorders