Upper extremity digital subtraction venography with gadoterate meglumine before fistula creation for hemodialysis.

Abstract

BACKGROUND:

The purpose of this study was to evaluate the feasibility, safety, and potential role of gadoterate meglumine (Gd-DOTA) as a contrast agent for upper extremity venography before the creation of an arteriovenous fistula (AVF) for nondialyzed renal insufficiency patients.

METHODS:

Over a 16-month period, 50 venographies were performed on end-stage renal insufficiency patients, using Gd-DOTA as a contrast agent on a high-resolution digital subtraction angiography system. Three sequences were performed on forearm, arm, and chest at 3 mL/sec for a total of 35 mL of Gd-DOTA. Examinations were reviewed by two radiologists for diagnostic and opacification quality. Tolerance was evaluated on the evolution of serum creatinine levels and occurrence of pain during injection.

RESULTS:

Good interobserver correlation was obtained in evaluating the feasibility of AVF creation by vein segment (0.64 < kappa < 0.88) and in relationship to opacification quality (0.62 to 0.87). No deterioration in renal function (creatinine level before and after) or pain was observed. Twenty-six patients underwent surgical creation of brachiobasilic (N = 8), brachiocephalic (N = 8), radiocephalic (N = 8), and cubitocephalic (N = 1) fistulas or insertion of a polytetrafluoroethylene (PTFE) graft (N = 1). Seventeen were awaiting AVF or were on peritoneal dialysis. Two died before surgery for reasons unconnected with the venography.

CONCLUSIONS:

Venography with Gd-DOTA is an effective and safe technique in planning AVFs for renal insufficiency patients.

• Authors: O Geoffroy, M Tassart, A F Le Blanche, A Khalil, V Duédal, J Rossert, J M Bigot, F P Boudghène
• Journal: Kidney international (Kidney Int) Vol. 59 Issue 4 Pg. 1491-7 (Apr 2001) ISSN: 0085-2538 [Print] United States
• PMID: 11260413 (Publication Type: Evaluation Study, Journal Article)

Chemical References

• Contrast Media
• Organometallic Compounds
• Meglumine
• Polytetrafluoroethylene
• gadoterate meglumine

Topics

• Adult
• Aged
• Aged, 80 and over
• Arm (blood supply)
• Arteriovenous Shunt, Surgical
• Blood Vessel Prosthesis
• Computers
• Contrast Media
• Feasibility Studies
• Female
• Humans
• Kidney Failure, Chronic (therapy)
• Male
• Meglumine
• Middle Aged
• Organometallic Compounds
• Phlebography
• Polytetrafluoroethylene
• Renal Dialysis
• Subtraction Technique