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Zero-iodinated contrast retrograde percutaneous coronary interventions of chronic total occlusions using gadolinium and imaging guidance: a case report of a patient with severe anaphylaxis to iodinated contrast
- Source :
- European Heart Journal: Case Reports
- Publication Year :
- 2020
- Publisher :
- Oxford University Press, 2020.
-
Abstract
- Background Gadolinium-based contrast agents have been used as an alternative to iodinated contrast agents for simple percutaneous coronary interventions (PCIs) in patients with obstructive coronary artery disease. Their use has been limited in complex PCI due to poor image quality with gadolinium contrast. Significant dilution of gadolinium is required in an effort to avoid malignant ventricular arrhythmias. Further, the recommended amount of gadolinium contrast that can be used is very limited. Case summary We describe a case of patient with severe anaphylaxis to iodinated contrast agents despite pre-exposure prophylaxis with steroids and histamine blockers who underwent intravascular imaging-guided PCI of chronic total occlusions (CTOs) of left anterior descending and dominant left circumflex arteries using gadolinium contrast. Discussion In patients with anaphylaxis to iodinated contrast agents (i) complex coronary interventions including CTO PCI can be successfully performed without use of iodinated contrast, and (ii) combination of intravascular ultrasound guidance and gadolinium-based contrast agents can be safely and effectively used to perform complex PCI.
- Subjects :
- medicine.medical_specialty
Percutaneous
Gadolinium
medicine.medical_treatment
Gadolinium contrast
chemistry.chemical_element
030204 cardiovascular system & hematology
Circumflex branch of left coronary artery
Complex coronary interventions
Percutaneous coronary intervention
Coronary artery disease
03 medical and health sciences
0302 clinical medicine
Iodinated contrast
medicine.artery
Intravascular ultrasound
Case report
medicine
Case Series
030212 general & internal medicine
cardiovascular diseases
Coronary heart disease (incl. Cardiac Intervention)
Zero-iodinated contrast
medicine.diagnostic_test
business.industry
medicine.disease
Contrast allergy
Chronic total occlusion
chemistry
Conventional PCI
cardiovascular system
Radiology
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- Language :
- English
- ISSN :
- 25142119
- Volume :
- 4
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- European Heart Journal: Case Reports
- Accession number :
- edsair.doi.dedup.....7e759230478278c10efcf4ef4fc88768