Renal artery stenting using gadodiamide arteriography in patients with baseline renal insufficiency.
OBJECTIVE
To investigate whether a contrast agent containing gadodiamide can reduce the incidence of contrast-induced nephropathy associated with renal artery stenting in patients with preexisting renal insufficiency.


METHODS
Between 1999 and 2002, gadodiamide-based arteriography was used in 20 patients (12 men; mean age 69 years) with significant baseline renal insufficiency (creatinine > or =1.7 mg/dL) undergoing renal artery stenting for > or =70% stenoses in 25 renal arteries. Baseline creatinine levels were compared to postprocedure and midterm follow-up levels.


RESULTS
Procedural success was 100%. An average of 74 mL of gadodiamide contrast was used per case. Four patients received an additional 30 mL (mean) of iodinated contrast due to poor image quality with gadodiamide alone. There was no significant change in mean creatinine levels at discharge (2.9 mg/dL) compared to baseline (3.0 mg/dL, p=0.72). At midterm follow-up, mean creatinine levels (2.4 mg/dL) were significantly lower compared to baseline (p=0.004).


CONCLUSIONS
Gadodiamide-based arteriography can be effectively used during RAS in patients with baseline renal insufficiency. This technique may enhance the renal-protective effect of renal artery stenting in this high-risk population with renal artery stenosis.
Washington Hospital Center, Georgetown University, Washington, DC 20010, USA.
Tareq S
TS
Harb
John R
JR
Laird
Robert S
RS
Dieter
Bhagat K
BK
Reddy
Donna
D
Whitman
Joseph C
JC
Babrowicz
Lowell F
LF
Satler
D000368:Aged; D000792:Angiography / Q000379:methods; D017130:Angioplasty; D019917:Blood Vessel Prosthesis Implantation; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008297:Male; D012077:Renal Artery / Q000000981:diagnostic imaging* / Q000601:surgery; D012078:Renal Artery Obstruction / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D051437:Renal Insufficiency / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D012189:Retrospective Studies; D015607:Stents
D003287:Contrast Media; C064925:gadodiamide; D019786:Gadolinium DTPA