CO2 and gadopentetate dimeglumine as alternative contrast agents for malfunctioning dialysis grafts and fistulas

CO2 and gadopentetate dimeglumine as alternative contrast agents for malfunctioning dialysis grafts and fistulas. Hemodialysis grafts and native fistulas are frequently evaluated angiographically utilizing iodinated contrast material to determine the cause of malfunction. Occasionally, patients are...

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Bibliographic Details
Published in:Kidney international 1998-09, Vol.54 (3), p.945-950
Main Authors: Spinosa, David J., Angle, J. Fritz, Hagspiel, Klaus D., Schenk, Worthington G., Matsumoto, Alan H.
Format: Article
Language:English
Subjects:
Adult
Aged
Angiography
Biological and medical sciences
Carbon Dioxide
Cardiovascular system
Contrast Media
dimeglumine
Female
fistulas
Gadolinium DTPA
grafts
hemodialysis
Humans
Investigative techniques, diagnostic techniques (general aspects)
Male
Medical sciences
Middle Aged
Radiodiagnosis. Nmr imagery. Nmr spectrometry
Renal Dialysis - adverse effects
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Summary:CO2 and gadopentetate dimeglumine as alternative contrast agents for malfunctioning dialysis grafts and fistulas. Hemodialysis grafts and native fistulas are frequently evaluated angiographically utilizing iodinated contrast material to determine the cause of malfunction. Occasionally, patients are not able to receive iodinated contrast material due to a history of previous severe allergic reaction or concern that iodinated contrast material could worsen renal function requiring premature initiation of permanent dialysis. We set out to test the feasibility of gadopentetate dimeglumine as an alternative contrast agent in conjunction with carbon dioxide (CO2) angiography in the evaluation and treatment of hemodialysis grafts and native fistulas in patients who have a contraindication to iodinated contrast material. Six patients with a malfunctioning hemodialysis graft and native fistula were evaluated. Four patients were successfully evaluated using carbon dioxide and gadopentetate dimeglumine. Two additional patients underwent balloon angioplasty using gadopentetate dimeglumine alone as the alternative contrast agent. All six patients successfully were evaluated and treated using gadopentetate dimeglumine either alone or as a supplement to CO2 angiography. Five of these patients had lesions successfully treated using gadopentetate dimeglumine alone or in combination with CO2 as the angiographic contrast agents. One patient underwent a successful diagnostic angiogram using gadopentetate dimeglumine and CO2 as alternative contrast agents and was subsequently treated with surgical revision. The gadopentetate dimeglumine angiograms identified the arterial anastomosis and more clearly identified stenotic lesions and venous outflow anatomy compared to carbon dioxide angiograms. Gadopentetate dimeglumine is useful as an alternative contrast agent in conjunction with CO2 in patients with malfunctioning hemodialysis grafts and fistulas, who have a contraindication to the administration of iodinated contrast material.
ISSN:0085-2538
1523-1755
DOI:10.1046/j.1523-1755.1998.00047.x