Einsatz von niederosmolarem Gadolinium zur angiographischen Darstellung und bei interventionell-radiologischen Eingriffen bei niereninsuffizienten Patienten

Abstract

To evaluate the benefit and feasibility of gadolinium contrast agents for intra-arterial use in diagnostic and therapeutic angiography in patients with renal insufficiency. In 15 patients with planned peripheral or renal vascular interventions digital subtraction angiography with intra-arterial administration of gadolinium (gadodiamide n = 14, gadolinium-DTPA n = 1) was performed. Gadolinium was used selectively after peripheral catheter placement, mainly as an adjunct to CO2 (n = 12), to assess the distal run-off vessels or to characterize stenotic lesions. In 14 cases gadolinium yielded good or satisfactory results that were superior to those of CO2 angiography in the femoropopliteal region and calf, but also to the aorto-iliac vessels and the renal arteries. A small amount of iodinated contrast media was administered due to insufficient contrast of gadolinium in one patient. Mean serum creatinine level after angiography (295 +/- 167 micromol/l; range 125 - 764 micromol/l) was not significantly different (p >/= 0,37) from the initial level (279 +/- 149 micromol/l; range 143 - 728 micromol/l). Gadolinium is a viable alternative contrast agent for digital subtraction angiography and percutaneous transluminal angioplasty in patients with renal insufficiency. It enhances the diagnostic evaluation of stenosis and run-off vessels.