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- Title
Upper extremity digital subtraction venography with gadoterate meglumine before fistula creation for hemodialysis.
- Authors
Geoffroy, Olivier; Tassart, Marc; Le Blanche, Alain-Ferdinand; Khalil, Antoine; Duédal, Viviane; Rossert, Jérôme; Bigot, Jean-Michel; Boudghène, Frank P.; Geoffroy, O; Tassart, M; Le Blanche, A F; Khalil, A; Duédal, V; Rossert, J; Bigot, J M; Boudghène, F P
- Abstract
<bold>Background: </bold>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.<bold>Methods: </bold>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.<bold>Results: </bold>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.<bold>Conclusions: </bold>Venography with Gd-DOTA is an effective and safe technique in planning AVFs for renal insufficiency patients.
- Subjects
VENOGRAPHY; ARTERIOVENOUS fistula; TREATMENT of chronic kidney failure; ARM; SURGICAL arteriovenous shunts; BLOOD vessel prosthesis; COMPARATIVE studies; COMPUTERS; DIGITAL diagnostic imaging; HEMODIALYSIS; RESEARCH methodology; MEDICAL cooperation; ORGANOMETALLIC compounds; POLYTEF; RESEARCH; SORBITOL; PILOT projects; EVALUATION research; CONTRAST media
- Publication
Kidney International, 2001, Vol 59, Issue 4, p1491
- ISSN
0085-2538
- Publication type
journal article
- DOI
10.1046/j.1523-1755.2001.0590041491.x