Power Injector Settings for EVAR

Recommended Settings

The European Society of Cardiology recommends a flow rate of ≥4 mL/sec for CT angiography of large vessels, including aortic imaging 1
A volume of 50-100 mL of contrast medium is appropriate for adequate vessel opacification 1
Higher flow rates (4-6 mL/sec) may be used for coronary and large vessel imaging, with volumes ranging from 50-160 mL depending on scan duration, as suggested by Circulation 2
Non-ionic iodinated contrast media with concentration ≥350 mg/mL should be used 1

The American College of Cardiology recommends that the power injector be flow-rate controlled and capable of delivering up to 50 mL/sec for cardiac and large vessel angiography 4, 5
Automatic detection and termination of over-pressure situations is essential, according to the American College of Cardiology 4, 5
The contrast material should be maintained at approximately 37°C using a syringe heater, as recommended by the American College of Cardiology 4, 5

A standard delay of 15 seconds between contrast injection and image acquisition is recommended for most patients, according to the European Heart Journal 6
An extended delay of 15-30 seconds may be used for patients with pulmonary arterial hypertension, right ventricular failure, or cardiac failure, as suggested by the European Heart Journal 6
The European Society of Cardiology recommends using a bolus-tracking method with a threshold of 100 HU for arterial phase imaging 1

An 18-gauge or larger cannula designed for power injection rates should be used, typically placed in an antecubital vein, as recommended by Circulation 2

Renal function should be assessed before selecting contrast concentration and volume, according to Praxis Medical Insights 3
Patients with eGFR <30 mL/min/1.73m² should use extremely low doses or consider alternative imaging, as suggested by Praxis Medical Insights 3
Proper hydration should be ensured before and after the procedure, according to Praxis Medical Insights 3
The American College of Cardiology recommends that the injector have audible signals indicating current flow >20 mA 4, 5
Trigger and remote controls should automatically terminate injection when released, as recommended by the American College of Cardiology 4, 5
Renal function should be monitored within 48-72 hours after contrast administration in high-risk patients, according to Praxis Medical Insights 3
Signs of contrast-induced acute kidney injury should be watched for in patients with pre-existing chronic kidney disease, as suggested by Praxis Medical Insights 3