The use of gadolinium chelates for x-ray digital subtraction angiography

RATIONALE AND OBJECTIVES. TO evaluate the feasibility and safety of using g adolinium chelates for x-ray digital subtraction angiography (DSA) in patie nts with contraindications to iodinated contrast material. METHODS. We performed 30 DSAs in 22 patients (5 females, 17 males; mean age 64.9 years) with contraindications to iodinated contrast media (renal insu fficiency: n = 28; hyperthyroidism: n = 1; contrast allergy: n = 2), Gadoli nium chelates were administered as 0.5 mol/L solutions (mean volume of gado linium chelates per patient was 34 +/- 19 mL). Gadolinium chelates were the sole contrast agent in 17 examinations, were used in conjunction with carb on dioxide (CO2) in 8 studies, (mean 212 +/- 226 mL), and were combined wit h the restricted use of nonionic iodinated contrast (mean 12.8 +/- 4.7 mL) in 6 examinations. We carried out 15 diagnostic angiographies and 15 percut aneous transluminal angioplasties. RESULTS. Use of gadolinium chelates allowed us to obtain diagnostic angiogr aphic images in all cases. However, the quality of angiograms was inferior compared with that obtained with iodinated contrast agents and superior com pared with CO2 as the contrast material. Adverse events were not noted. Mea n serum creatinine was 2.6 +/- 1.5 mg/dL before and 2.3 +/- 1.0 mg/dL after DSA, No patient developed contrast-induced nephropathy, CONCLUSIONS, Gadolinium chelates produce an x-ray DSA intermediate in image quality between iodinated contrast and CO2. Digital subtraction angiograph y with intra-arterial gadolinium chelate administration may offer an altern ative to iodinated contrast material in patients with contraindications to iodine.