What is the policy regarding elevated creatinine levels and intravenous contrast for CT scans?
If serum Cr <1.6, proceed with intravenous contrast. If serum Cr is 1.7 to 1.9, take Mucomyst 600 mg PO BID the day before and the day of the exam. If serum Cr is >1.9, nephrology consult is recommended before intravenous contrast. Also, no more than 1 study with iodinated contrast is recommended in a 24 hour period. How do you decide if a patient is a suitable candidate for CT angiography examinations? see chart here Studies have shown that interpretation of CTA examinations is limited by vessel calcifications. Patients with diabetes, coexisting cardiac disease, and age greater than 80 have been shown to have a sufficient degree of vascular calcifications that would limit CTA. Also, patients with certain degrees of renal insufficiency may be better served by an MRA examination rather than CTA. This flowchart outlines our basic approach to screening patients for CTA examination: What coagulation cutoff parameters do you use for invasive radiological prodedures? In general, platelets >
