title: Ultrasound and fluoroscopic-guided angioplasty over the aortic bifurcation in a patient with previous severe reaction to contrast medium.
abstract: OBJECTIVE
  To describe a case of ultrasound and fluoroscopic-guided angioplasty necessitated by a patient history of allergic reaction to contrast medium.
  
  
  METHODS
  A 60-year-old man with intermittent right leg claudication had a focal >70% stenosis in the right external iliac artery that was amenable to balloon dilation; however, the patient reported a severe reaction to radiographic contrast medium 10 years previously. Angioplasty was begun with transaortic access to the iliac artery lesion under fluoroscopic guidance only. On-table duplex imaging confirmed the lesion site and reference diameters for balloon selection. The balloon was filled with contrast medium to provide rapid positioning under fluoroscopy. An on-table postangioplasty duplex scan showed improvement in the lumen contour and confirmed a reduction in the peak systolic velocity. At the 1-year follow-up, the patient reports no symptoms referable to the treated segment.
  
  
  CONCLUSIONS
  The combination of ultrasound and fluoroscopy facilitated quick and efficient balloon dilation of an isolated iliac lesion without the use of any contrast medium.
authors.affiliation: Department of Clinical Radiology, Bristol Royal Infirmary, England, UK.
authors.forename: C
authors.initials: C
authors.lastname: Cook
authors.forename: M
authors.initials: M
authors.lastname: Rees
mesh_terms: D000800:Angioplasty, Balloon / Q000379:methods*; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D003287:Contrast Media / Q000009:adverse effects; D004342:Drug Hypersensitivity / Q000209:etiology; D005471:Fluoroscopy; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging; D007383:Intermittent Claudication / Q000000981:diagnostic imaging / Q000628:therapy*; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional / Q000379:methods; D018616:Ultrasonography, Doppler, Duplex; D018084:Ultrasonography, Interventional / Q000379:methods
chemical_list: D003287:Contrast Media