Endovascular treatment of an infrarenal aortic aneurysm with a stent graftand exclusive use of gadolinium as contrast agent in chronic renal insufficiency

History: A 64-year-old obese man with radiocontrast-induced nephropathy, wh ich required temporary hemodialysis, was referred for treatment of an infra renal abdominal aortic aneurysm detected incidentally. Comorbidities were o besity (BMI 44.1), non-insulin dependent diabetes mellitus, arterial hypert ension, COPD, and renal failure with decompensated retention. Investigations: MRI demonstrated a 6.1cm diameter infrarenal partially thro mbosed aortic aneurysm which extended to the aortic bifurcation. Its morpho logy was favourable for endovascular treatment. Treatment and Course: An aortobiiliac stent graft was inserted after bilate ral arterial femoral cut-down. As a contrast agent we administered 0.5 mola r gadoteridol solution only. The total volume used was 90ml (0.375 mmol/kg body weight). The aneurysm was completely excluded. No further signs of ren al deterioration occurred. Conclusion: Non-nephrotoxic gadolinium-containing contrast media allow mini mal invasive exclusion of infrarenal aortic aneurysms with use of stent gra fts in patients in whom conventional iodinated x-ray contrast agents are co ntraindicated.