ヨード造影剤アレルギー患者に対するガドリニウム造影剤と血管内超音波を用いたステントグラフト内挿術

Endovascular Stent Grafting Using Gadolinium-based Contrast Agent and Intravascular Ultrasound in a Patient of Iodinated Contrast Media Allergy

ヨード造影剤アレルギーのある左鎖骨下動脈瘤の患者にガドリニウム造影剤と血管内超音波（IVUS）を使用してステントグラフト内挿術を実施したため，若干の文献的考察を加えて報告する．

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.