title: The use of gadolinium chelates for X-ray digital subtraction angiography.
abstract: OBJECTIVE
  To evaluate the feasibility and safety of using gadolinium chelates for x-ray digital subtraction angiography (DSA) in patients 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 insufficiency: n = 28; hyperthyroidism: n = 1; contrast allergy: n = 2). Gadolinium chelates were administered as 0.5 mol/L solutions (mean volume of gadolinium chelates per patient was 34 +/- 19 mL). Gadolinium chelates were the sole contrast agent in 17 examinations, were used in conjunction with carbon dioxide (CO2) in 8 studies, (mean 212 +/- 226 mL), and were combined with the restricted use of nonionic iodinated contrast (mean 12.8 +/- 4.7 mL) in 6 examinations. We carried out 15 diagnostic angiographies and 15 percutaneous transluminal angioplasties.
  
  
  RESULTS
  Use of gadolinium chelates allowed us to obtain diagnostic angiographic images in all cases. However, the quality of angiograms was inferior compared with that obtained with iodinated contrast agents and superior compared with CO2 as the contrast material. Adverse events were not noted. Mean 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 angiography with intra-arterial gadolinium chelate administration may offer an alternative to iodinated contrast material in patients with contraindications to iodine.
authors.affiliation: Department of Radiology, University of Wisconsin Hospital and Clinics, Madison, Wisconsin, USA. hwagner@mail.radiology.wisc.edu
authors.forename: H J
authors.initials: HJ
authors.lastname: Wagner
authors.forename: M
authors.initials: M
authors.lastname: Kalinowski
authors.forename: K J
authors.initials: KJ
authors.lastname: Klose
authors.forename: H
authors.initials: H
authors.lastname: Alfke
mesh_terms: D000368:Aged; D015901:Angiography, Digital Subtraction / Q000379:methods*; D002614:Chelating Agents; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D002614:Chelating Agents; D003287:Contrast Media; C064925:gadodiamide; D019786:Gadolinium DTPA