The use of gadolinium chelates as an alternative radiographic contrast agent for use with flat panel detector angiography

Abstract

Gadolinium chelates can be utilized as a fluoroscopic contrast agent when iodinated contrast is contraindicated. However, the nephrotoxicity of gadolinium at radiographic doses limits its role as fluoroscopic contrast. Gadolinium chelate-enhanced digital subtraction angiography (DSA) is particularly limited by the kV of DSA, where gadolinium chelates are relatively more radiolucent. Flat panel detectors improve conspicuity of gadolinium chelates during DSA and should be employed where possible.

CO2-based C-arm computed tomography (CACT) of the pelvic arteries: feasibility and diagnostic performance in comparison to CO2-angiography in patients with peripheral arterial disease

“…It facilitates exact diagnosis for arterial stenoses and occlusions and provides roadmaps for angioplasty or stent positioning. There are a few studies on the use of gadolinium-based contrast agents for DSA (25,26). Initially recommended for patients with renal impairment, the safety profile and corresponding medicolegal liability associated with gadolinium-based contrast agents changed approximately five years ago, and DSA with gadolinium-compounds is now only used in patients with PAD with severe allergic reactions to iodinated contrast agents (25,26).…”