Heidel Justin S, Theeuwes Chloe, Said Ahmad, Ahmad Saad S
Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
Department of Medicine, University of Cincinnati Medical Center, Cincinnati, Ohio.
J Soc Cardiovasc Angiogr Interv. 2025 May 13;4(6):103617. doi: 10.1016/j.jscai.2025.103617. eCollection 2025 Jun.
Contrast allergies may range from minor to life-threatening, such as Stevens-Johnson syndrome, and pose a challenge to obtaining timely coronary angiography. Here, we present a complex patient with a history of 5-vessel coronary artery bypass grafting and end-stage renal disease who required native coronary and bypass graft angiogram prior to listing for renal transplant. Due to a history of iodinated contrast-induced Stevens-Johnson syndrome, this patient was unable to undergo standard angiography. This diagnostic challenge was overcome with the safe, hybrid approach of using intravascular ultrasound to guide minimal administration of gadolinium contrast media to obtain a complete angiography.
造影剂过敏的严重程度不一，从轻微到危及生命，如史蒂文斯-约翰逊综合征，这给及时进行冠状动脉造影带来了挑战。在此，我们介绍一位复杂患者，他有5支血管冠状动脉旁路移植术病史和终末期肾病，在列入肾移植名单之前需要进行自身冠状动脉和旁路移植血管造影。由于有碘造影剂诱发的史蒂文斯-约翰逊综合征病史，该患者无法进行标准血管造影。通过使用血管内超声引导少量注射钆造影剂以获得完整血管造影的安全、混合方法，克服了这一诊断难题。
