[Digital substraction angiography using gadolinium as contrast medium for patients with renal failure. A study of 15...

To study the feasibility of IA-DSA for diagnostic or interventional purposes using gadolinium (Gd) as a contrast medium (CM) for patients with poor renal function.

This study is about 15 patients with renal insufficiency (creat. > 133 micromol/l) who needed IA-DSA for diagnostic or interventional purposes. Gd was used as a CM at a dose < or = 0.4 micromol/kg and a concentration > or = 75%. Serum creatinine level was evaluated before, at 24 h and 48 h after injection of Gd. An increase of creat. > or = 44 micromol/l was considered significant. Image quality was evaluated by two specialists.

In 14/15 (93%) patients no significant elevation of the serum creat. level was noted. The images are of good to medium quality, the diagnostic or therapeutic purpose was however reached. Image quality depends on Gd concentration; the feasibility of the exam is limited by the quantity of Gd used and its dilution. The procedure is well tolerated without side effects.

Gd allows arteriograms of adequate quality for diagnostic or therapeutic purposes without renal complications at doses used until now (0.4 micromol/kg). The procedure is easy to perform but only one region or organ can be studied in one procedure considering the relatively small volume of contrast allowed.