Renal insufficiency: usefulness of gadodiamide-enhanced renal angiography to supplement CO2-enhanced renal angiography for diagnosis and percutaneous treatment.
Renal insufficiency: usefulness of gadodiamide-enhanced renal angiography to supplement CO2-enhanced renal angiography for diagnosis and percutaneous treatment.
复制标题
肾功能不全：钆双酰胺增强肾血管造影可作为二氧化碳增强肾血管造影的补充，用于诊断和经皮治疗。
作者：
D. Spinosa;A. Matsumoto;J. Angle;K. Hagspiel;J. Mcgraw;C. Ayers
目的
确定钆双胺是否是一种安全、有用的血管造影造影剂，有助于肾功能不全患者肾动脉狭窄的诊断和经皮治疗。
材料和方法
使用钆双胺（总剂量，0.3 mmol/kg）和 CO2 作为动脉内造影剂，对 24 名肾功能不全患者进行了 25 次诊断性肾血管造影和经皮肾介入治疗。术前 24 小时内以及术后 24 小时和 48 小时内获取血清肌酐水平。血清肌酐增加超过 44 μmol/L 被认为具有临床意义。将钆双酰胺增强血管造影与 CO2 增强血管造影进行比较。
结果
25 次手术中有 23 次 (92%) 48 小时后血清肌酐水平没有增加。一名患有肾移植急性和慢性排斥反应的患者和一名有胆固醇栓塞证据的患者在 48 小时内血清肌酐水平出现了临床上重要的升高。在基线水平相对较低的患者中，未观察到肌酐水平明显升高 (n = 19)。钆双酰胺增强血管造影似乎比二氧化碳增强血管造影更能帮助识别肾动脉闭塞、观察不完全充满二氧化碳的肾血管以及确定干预进展。
结论
对于肾功能不全患者来说，钆双胺似乎是一种安全且有用的动脉内造影剂，可用于补充或确认 CO2 增强血管造影结果。
PURPOSE
To determine whether gadodiamide is a safe and useful angiographic contrast agent for help in diagnosis and percutaneous treatment of renal artery stenosis in patients with renal insufficiency.
MATERIALS AND METHODS
Diagnostic renal angiography and percutaneous renal interventions were performed by using gadodiamide (total dose, 0.3 mmol/kg) and CO2 as intraarterial contrast agents in 25 procedures in 24 patients with renal insufficiency. Serum creatinine levels were obtained within 24 hours before and at 24 and 48 hours after the procedure. Increases in serum creatinine of more than 44 mumol/L were considered clinically important. Gadodiamide-enhanced angiograms were compared with CO2-enhanced angiograms.
RESULTS
In 23 (92%) of 25 procedures, there was no increase in serum creatinine level at 48 hours. One patient with acute and chronic rejection of a renal transplant and one with evidence of cholesterol embolization had a clinically important increase in serum creatinine level at 48 hours. No marked increase in creatinine level was observed in patients with relatively low baseline levels (n = 19). Gadodiamide-enhanced angiograms appeared to be better than CO2-enhanced angiograms for help in identifying renal artery occlusions, visualizing renal vessels incompletely filled with CO2, and determining the progress of intervention.
CONCLUSION
Gadodiamide appears to be a safe and useful intraarterial contrast agent in patients with renal insufficiency and can be used to supplement or confirm CO2-enhanced angiographic findings.
影响因子：
2.5
作者：
Johnson,DB;Lerner,CA;Prince,MR;Kazanjian,SN;Narasimham,DL;Leichtman,AB;Cho,KJ
通讯作者：
Cho,KJ
肾动脉疾病手术血运重建的趋势。
DOI：
--
发表时间：
1987
期刊：
JAMA
影响因子：
--
作者：
Novick,AC;Ziegelbaum,M;Vidt,DG;GiffordJr,RW;Pohl,MA;Goormastic,M
通讯作者：
Goormastic,M