The authors reported a subclavian artery stenting (SAS) using
gadolinium contrast medium. The patient was a 65-year-old female who presented
dizziness and right upper extremity
pain with movement. Digital subtraction angiography revealed right subclavian artery occlusion with
subclavian steal phenomenon. We tried to treat this lesion using SAS. However, iodinated contrast medium caused the
allergy in this patient and the treatment was discontinued. Therefore, SAS was performed with
gadolinium contrast medium. Using
gadolinium contrast medium, it is possible to confirm large arteries like innominate artery and subclavian artery. The stenting procedure was performed without complication. The usage of
gadolinium contrast medium has the limit and some strategies are important to reduce the usage of
gadolinium contrast medium in SAS. First, PercuSurge GuardWire® was placed in the right internal carotid artery to confirm the anatomy, to decide working angle, and to treat the common carotid artery in case of dissection. Second, a "U" shaped guide wire was placed in the distal end from the brachial artery. Guide wire from femoral side was able to pass the lesion at midpoint of the "U" shaped one. SAS using
gadolinium contrast medium may be an alternative treatment if a patient with
subclavian artery stenosis or occlusion is allergic to iodinated contrast medium.