Endovascular Therapy Using Diluted Contrast Medium for Critical Limb Ischemia in a Patient with Chronic Kidney Disease

被引:3
作者
Hayakawa, Naoki [1 ]
Kodera, Satoshi [1 ,2 ]
Ohki, Noriyoshi [3 ]
Kushida, Syunichi [1 ]
Morita, Hiroyuki [2 ]
Kanda, Junji [1 ]
Komuro, Issei [2 ]
机构
[1] Asahi Gen Hosp, Dept Cardiovasc Med, 1-1326 Asahi, Chiba 2892511, Japan
[2] Univ Tokyo Hosp, Dept Cardiovasc Med, Tokyo, Japan
[3] Asahi Gen Hosp, Dept Radiol, Chiba, Japan
关键词
Contrast-induced nephropathy; Below-the-knee intervention; Digital subtraction angiography; INDUCED NEPHROPATHY; PERCUTANEOUS CORONARY; ULTRASOUND GUIDANCE; PREVENTION; ANGIOGRAPHY; ACETYLCYSTEINE; METAANALYSIS; ANGIOPLASTY;
D O I
10.1536/ihj.18-125
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
A high percentage of patients with critical limb ischemia have concurrent chronic kidney disease (CKD). However. endovascular therapy (EVT) can be problematic in CKD patients. Thus, we developed a method of EVT using digital subtraction angiography (DSA) with diluted contrast medium (low-concentration DSA), wherein DSA parameters were adjusted for diluted contrast angiography (1:10 dilution). Herein, we report the case of an 88-year-old woman with a foot wound and severe CKD. Her estimated glomerular filtration rate was 7.9 mL/minute/1.73 m(2) . Therefore, EVT was performed with low-concentration DSA. Control angiography revealed total occlusion of the anterotibial and posterotibial arteries as well as severe stenosis of the peroneal artery. EVT with ballooning of the below-the-knee (BTK) lesions resulted in sufficient flow to the wound. Angiographic images of sufficient quality and visible wound blush were obtained with 1:10 diluted contrast medium. Because only 20 mL of contrast medium was required, renal function was preserved. EVT using DSA with diluted contrast medium was shown to be an effective BTK intervention in this CKD patient.
引用
收藏
页码:226 / 230
页数:5
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