Purpose: Patients with renal insufficiency or other contraindications to iodine-based contrast agents present a significant management dilemma when angiography or interventional procedures are required. We describe the use of gadolinium as an alternative contrast agent for intravenous digital subtraction angiography (IV-DSA) and interventional procedures of the upper extremity veins.
Methods: Sixteen patients with symptoms of with moderate renal insufficiency underwent digital subtraction angiography for upper extremity and subclavian venography. Angiographic studies were obtained using gadolinium as a contrast agent. In six patients we used stents.
Results: Diagnostic images were obtained in all cases. No patient suffered a complication related to the use of gadolinium, and no patient demonstrated worsened renal function after the procedure.
Conclusion: In the setting of a contraindication to iodine-based contrast agents, gadolinium represents an important alternative contrast material that allows for the visualization of and interventional procedures in the upper extremity veins.