Document Detail


[Subclavian artery stenting using gadolinium contrast medium in a case with iodine allergy].
MedLine Citation:
PMID:  22538283     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
The authors reported a subclavian artery stenting (SAS) using gadolinium contrast medium. The patient was a 65-year-old female who presented dizziness and right upper extremity pain with movement. Digital subtraction angiography revealed right subclavian artery occlusion with subclavian steal phenomenon. We tried to treat this lesion using SAS. However, iodinated contrast medium caused the allergy in this patient and the treatment was discontinued. Therefore, SAS was performed with gadolinium contrast medium. Using gadolinium contrast medium, it is possible to confirm large arteries like innominate artery and subclavian artery. The stenting procedure was performed without complication. The usage of gadolinium contrast medium has the limit and some strategies are important to reduce the usage of gadolinium contrast medium in SAS. First, PercuSurge GuardWire<sup>R</sup> was placed in the right internal carotid artery to confirm the anatomy, to decide working angle, and to treat the common carotid artery in case of dissection. Second, a "U" shaped guide wire was placed in the distal end from the brachial artery. Guide wire from femoral side was able to pass the lesion at midpoint of the "U" shaped one. SAS using gadolinium contrast medium may be an alternative treatment if a patient with subclavian artery stenosis or occlusion is allergic to iodinated contrast medium.
Authors:
Michiyuki Miyamoto; Takeshi Asano; Toshiya Osanai; Shogo Endo; Naoki Nakayama; Satoshi Kuroda; Kiyohiro Houkin
Publication Detail:
Type:  English Abstract; Journal Article    
Journal Detail:
Title:  No shinkei geka. Neurological surgery     Volume:  40     ISSN:  0301-2603     ISO Abbreviation:  No Shinkei Geka     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-04-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0377015     Medline TA:  No Shinkei Geka     Country:  Japan    
Other Details:
Languages:  jpn     Pagination:  415-20     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Hokkaido University Graduate School of Medicine.
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