Gadolinium dimeglumine: an alternative contrast agent for digital subtraction angiography

The aim of this study was to evaluate gadolinium diethylenetriaminepenta-ac etic acid (Gd-DTPA) as an alternative contrast agent for digital subtractio n angiography (DSA) in patients with renal insufficiency or previous anaphy lactic reaction to iodinated contrast agents. We performed 34 DSAs in 31 pa tients by use of the commercially available 0.5-M Gd-DTPA solution (Magnevi st, Schering, Berlin, Germany). The contrast material was power- or hand-in jected at the same rate as iodinated contrast material, without exceeding a total amount of 0.4 mmol/kg body weight. In 18 studies Gd-DTPA was the sol e contrast agent. In 9 cases gadolinium injections were combined with carbo n dioxide. Restricted non-ionic contrast medium injections were administere d to complete the examinations in 7 cases and for comparative purposes in 1 case. Cerebral and carotid arteries, one superior limb, abdominal aorta, r enal arteries? renal transplants, iliac arteries and inferior limbs were im aged, and ten endovascular interventional procedures, including three trans jugular intrahepatic percutaneous stent shunts, were per farmed. No side ef fects were observed. Diagnostic angiographic images were obtained in all ca ses except in 5 of the 8 distal run-off studies. Gadolinium-based contrast can produce clinically useful angiograms in patients with a contra-indicati on to iodine who must undergo angiography.