title: Percutaneous carotid angioplasty and stenting with the use of gadolinium in lieu of iodinated contrast medium: technical case report and review of the literature.
abstract: OBJECTIVE
  We describe a patient who underwent percutaneous transluminal carotid angioplasty and stent placement with the use of intra-arterial gadolinium (Gd-DTPA) instead of iodinated contrast medium. This represents one of the first published reports of the use of Gd-DTPA as an angiographic contrast agent for an interventional neuroradiological procedure.
  
  
  METHODS
  A 75-year-old man with renal insufficiency and multiple comorbidities developed amaurosis fugax. Doppler examination revealed high-grade stenosis of the right internal carotid artery.
  
  
  METHODS
  The patient underwent percutaneous transluminal balloon angioplasty with endovascular stent placement for 95% narrowing of the proximal right internal carotid artery. Because of his impaired renal function, the procedure was performed with the use of Gd-DTPA as the sole contrast agent. Approximately 60 ml of contrast medium (twice the volume typically used for a magnetic resonance imaging study) was used. There were no neurological, renal, or other complications.
  
  
  CONCLUSIONS
  Intra-arterially administered Gd-DTPA may be substituted for iodinated contrast agents in complex neuroendovascular procedures. This capacity expands the armamentarium for interventional neuroradiological procedures.
authors.affiliation: Department of Neurological Surgery, Keck School of Medicine, University of Southern California, 1200 north State Street, Los Angeles, CA 90033-1029, USA. amar@aya.yale.edu
authors.forename: A P
authors.initials: AP
authors.lastname: Amar
authors.forename: D W
authors.initials: DW
authors.lastname: Larsen
authors.forename: G P
authors.initials: GP
authors.lastname: Teitelbaum
mesh_terms: D000368:Aged; D015901:Angiography, Digital Subtraction; D000800:Angioplasty, Balloon; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D003287:Contrast Media; D019786:Gadolinium DTPA; D006801:Humans; D007269:Injections, Intra-Arterial; D008297:Male; D015607:Stents
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA