title: Use of gadolinium for carotid artery angiography and stenting in patients with renal insufficiency.
abstract: Use of iodinated contrast media (ICM) for angiography can result in contrast-induced nephropathy (CIN). Gadolinium-based contrast media (GCM) have been used in angiography with a goal to reduce the incidence of CIN. We performed a retrospective analysis involving 85 patients with renal insufficiency who underwent 97 carotid artery angiography and stenting (CAAS) procedures with a combination of GCM and ICM. The incidence of peri-procedural death, Q wave myocardial infarction (QWMI), stroke and CIN were recorded. Patients in GCM group had worse preprocedure renal function compared to ICM group. There were no peri-procedural deaths or QWMI in both groups. The incidence of stroke was 2.2% in GCM group and 0% in ICM group. The incidence of CIN were similar in GCM and ICM groups (8.5% vs. 10%, respectively, p NS). However, the predicted risk of CIN was 18.5% for GCM group and 10.4% for ICM group. Use of GCM and ICM combination for CAAS resulted in a 50% reduction in the incidence of predicted CIN risk compared to ICM.
authors.affiliation: Department of Medicine, Drexel University College of Medicine Philadelphia, PA, USA. vamsee_10@hotmail.com
authors.forename: Vamsee
authors.initials: V
authors.lastname: Yaganti
authors.forename: Firas
authors.initials: F
authors.lastname: Alani
authors.forename: Sushmita
authors.initials: S
authors.lastname: Yaganti
authors.forename: Sheldon
authors.initials: S
authors.lastname: Goldberg
authors.forename: Daniel
authors.initials: D
authors.lastname: McCormick
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000009:adverse effects / Q000379:methods; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000379:methods; D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy; D002533:Cerebral Angiography / Q000009:adverse effects / Q000379:methods; D016009:Chi-Square Distribution; D003287:Contrast Media / Q000009:adverse effects; D005260:Female; D019786:Gadolinium DTPA / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D007479:Iopamidol / Q000009:adverse effects; D007674:Kidney Diseases / Q000097:blood / Q000139:chemically induced / Q000453:epidemiology; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D051437:Renal Insufficiency / Q000150:complications*; D012189:Retrospective Studies; D012449:Safety; D015607:Stents; D020521:Stroke / Q000453:epidemiology / Q000209:etiology; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D007479:Iopamidol; D019786:Gadolinium DTPA