Hirahara Hiroyuki, Watanabe Maya, Sugawara Masaaki
Department of Cardiovascular Surgery, Japanese Red Cross Nagaoka Hospital, Nagaoka, Japan.
Kyobu Geka. 2021 Nov;74(12):983-986.
A 75-year-old male with a history of allergy to iodinated contrast media was referred for the treatment of the left subclavian artery aneurysm. The aneurysm was saccular and maximum diameter over 30 mm. Stent grafting was performed with the use of gadolinium-based contrast agent and intravascular ultrasound (IVUS). Ipsilateral vertebral artery was temporarily occluded with a balloon catheter to protect against distal embolism. The IVUS reduced the amount of gadolinium-based contrast agent. There were no neurological, renal or other complications after the treatment. Stent grafting of the left subclavian artery aneurysm may be safely performed with gadolinium-based contrast agent and IVUS, even if iodinated contrast media is contraindicated.
一名75岁男性，有对碘化造影剂过敏史，因左锁骨下动脉瘤前来治疗。该动脉瘤为囊状，最大直径超过30毫米。使用钆基造影剂和血管内超声（IVUS）进行了支架植入术。同侧椎动脉用球囊导管暂时闭塞以防止远端栓塞。IVUS减少了钆基造影剂的用量。治疗后无神经、肾脏或其他并发症。即使碘化造影剂禁忌，左锁骨下动脉瘤的支架植入术也可使用钆基造影剂和IVUS安全进行。
