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Gadolinium:Nonionic Contrast Media (1:1) Coronary Angiography in Patients With Impaired Renal Function

Ankara University Department of Cardiology, Heart Center, Turkey, tamsay{at}hotmail.com

Sibel Turhan, MD

Ankara University Department of Cardiology, Heart Center, Turkey

Ömer Akyürek, MD

Ankara University Department of Cardiology, Heart Center, Turkey

Mustafa Kilickap, MD

Ankara University Department of Cardiology, Heart Center, Turkey

This study was to test safety and efficacy of 1:1 mixture of gadolinium:nonionic contrast media in avoiding contrast nephropathy during coronary angiography in patients with renal dysfunction. Although "off label" for x-ray angiography, gadolinium has drawn attention for its potential to avoid contrast nephropathy during coronary angiography. Initial data seem promising. Patients with a baseline creatinine of 1.5 mg/dl or more were included. In order to minimize contrast nephropathy risk, all patients were thoroughly hydrated and treated by N-acetylcysteine. After coronary angiography and/or percutaneous coronary intervention, renal function tests were remeasured on days 1, 2, and 3. A rise of 0.5 mg/dl or more in creatinine value in the following 3 days or the need for dialysis were considered as a contrast nephropathy event. Twenty-six patients were enrolled in this study. Ten were women and 16 were men. The mean age was 65.7 ± 11. Baseline creatinine value was 2.47 ± 0.74 mg/dl. The total amount of contrast medium used on 1:1 fashion was 57.1 ± 27.2 ml. No procedure-related cardiac complication or contrast nephropathy event occurred in this study. Although there was a slight loss in image quality, we felt that the results were adequate for interpretation. Although "off label," using gadolinium contrast media in a 1:1 mixture with standard nonionic low osmolar contrast media seems to be a viable option in decreasing the likelihood of contrast nephropathy. Further evaluation appears to be warranted.

This version was published on November 1, 2007

Angiology, Vol. 58, No. 5, 561-564 (2007)
DOI: 10.1177/0003319707303640


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