iothalamate-meglumine and Arterial-Occlusive-Diseases

In many patients with peripheral vascular disease, conventional arteriograms are not adequate to make proper preoperative decisions. In the past, these inadequate studies led to surgical exploration of vessels and intraoperative angiography to determine operability. Such efforts prolonged operating time and potentially had adverse effects on amputation levels. Recently, intra-arterial digital subtraction angiography (IDSA) has provided an excellent means to further evaluate these patients preoperatively. We presently have 30 patients in whom IDSA supplemented routine aortography and runoff studies. When standard angiographic studies were considered inadequate, the catheter was positioned appropriately and IDSA was obtained. Inadequate lower extremity distal runoff in 23 patients and no proximal or distal runoff in seven patients prompted the IDSA. The IDSA study yielded further information on all patients, and 26 of 30 patients underwent successful bypass operation. In all 17 patients having femoropopliteal or femorotibial bypass, the IDSA was confirmed by an intraoperative (after bypass) angiogram. Nine patients had inflow procedures, and operative findings corroborated the IDSA. Two patients refused surgery and two patients were not candidates for revascularization. The IDSA study provided an accurate "road map," eliminated unnecessary vessel exploration, saved vital operative time, and prevented compromise of potential amputation levels.

Topics: Aged; Angiography; Arterial Occlusive Diseases; Femoral Artery; Humans; Iothalamate Meglumine; Leg; Male; Middle Aged; Preoperative Care; Subtraction Technique

Whereas most ocular complications following cerebral angiography are benign and transient, central retinal artery occlusion following cerebral angiography produces severe permanent visual deficits in nearly 40% of patients. Physicians ordering and performing cerebral angiography should be aware of this complication, since immediate attention to patients with visual disturbance from central retinal artery occlusion may save useful vision. All previously reported cases of central retinal artery occlusion following cerebral angiography have occurred after direct percutaneous carotid angiography. We report a case of central retinal artery occlusion following transfemoral cerebral angiography using a #5 French catheter and meglumine iothalamate (Conray-60) contrast.

Topics: Arterial Occlusive Diseases; Blindness; Carotid Artery, Internal; Cerebral Angiography; Endarterectomy; Fundus Oculi; Humans; Iothalamate Meglumine; Male; Middle Aged; Retinal Artery; Vision, Ocular

Topics: Adult; Arterial Occlusive Diseases; Cerebral Angiography; Female; Humans; Iothalamate Meglumine; Middle Aged; Moyamoya Disease; Tomography, X-Ray Computed

Topics: Adult; Aged; Angiography; Arterial Occlusive Diseases; Femoral Artery; Humans; Injections, Intra-Arterial; Iothalamate Meglumine; Middle Aged; Osmolar Concentration; Pulmonary Edema

Complete evaluation of the aortoiliac femoropopliteal system is necessary for the proper evaluation of lower extremity peripheal vascular ischemic disease. We have used a modified infrarenal translumbar approach since it is both safely and rapidly performed. An analysis of 212 consecutive cases (the last 182 with translumbar technic) revealed that 72 per cent of patients had significant atherosclerotic involvement of the aorta or one or more common or external iliac arteries, 43 per cent had significant bilateral involvement, and it was judged that retrograde femoral catheterization would have been difficult or impossible in 38 per cent. Biplane aortoiliac evaluation was added in our last seventy-nine studies. This provided additional diagnostic help in thirty-six of these cases and revealed an abnormality not otherwise visible in six of these patients. There were no serious complications in this series.

Topics: Aorta, Abdominal; Aortic Diseases; Aortography; Arterial Occlusive Diseases; Arteriosclerosis; Catheterization; Diatrizoate; Diatrizoate Meglumine; Humans; Iliac Artery; Iothalamate Meglumine