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Intravascular ultrasound‐guided central vein angioplasty and stenting without the use of radiographic contrast agents
Author(s) -
Matthews Ray,
Thomas Joseph
Publication year - 2008
Publication title -
journal of clinical ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.272
H-Index - 61
eISSN - 1097-0096
pISSN - 0091-2751
DOI - 10.1002/jcu.20389
Subject(s) - medicine , iodinated contrast , intravascular ultrasound , angioplasty , radiology , stenosis , stent , respiratory distress , surgery , computed tomography
Patients with contraindications to iodinated radiographic contrast agents present a significant challenge during endovascular intervention. A 46‐year‐old man with end‐stage renal disease and a normally functioning left upper extremity arteriovenous fistula presented with severe left arm edema. The patient's history included repeated severe anaphylactoid reactions with severe respiratory distress upon exposure to iodinated contrast. In an attempt to avoid the use of iodinated contrast, angioplasty and stent placement of a severe central venous stenosis were performed using only fluoroscopy and intravascular sonography. In patients unable to receive iodinated contrast secondary to anaphylactoid reactions, intravascular sonography can be used to guide angioplasty and stenting of central venous stenosis. © 2008 Wiley Periodicals, Inc. J Clin Ultrasound, 2008.