Skip to main content
SpringerLink
Log in

Contrast-free diagnosis and treatment of coronary artery disease guided by integrated cardiac imaging: concept and first clinical experience

  • Case Report
  • Published:
Cardiovascular Intervention and Therapeutics Aims and scope Submit manuscript

Abstract

The use of iodinated contrast media (ICM) remains a potential hazard for patients undergoing diagnostic cardiac imaging and percutaneous coronary intervention. In particular patients with history of prior adverse reaction to a contrast agent are at a high risk in case of re-exposure, even if designated premedication is administered. Based on a patient with recurrent angina pectoris and history of systemic anaphylactic reaction to ICM, we describe the logical stepwise approach from diagnostic imaging to safe and successful imaging guided percutaneous coronary intervention without the use of contrast agent.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

References

  1. Idee JM, Pines E, Prigent P, Corot C. Allergy-like reactions to iodinated contrast agents. A critical analysis. Fundam Clin Pharmacol. 2005;19:263–81.

    Article  PubMed  CAS  Google Scholar 

  2. Liccardi G, Lobefalo G, Di Florio E, Di Iorio C, Occhiochiuso L, Romano L, et al. Strategies for the prevention of asthmatic, anaphylactic and anaphylactoid reactions during the administration of anesthetics and/or contrast media. J Investig Allergol Clin Immunol. 2008;18:1–11.

    PubMed  CAS  Google Scholar 

  3. Ogata N, Matsukage T, Toda E, Tamiya S, Fujii T, Nakazawa G, et al. Intravascular ultrasound-guided percutaneous coronary interventions with minimum contrast volume for prevention of the radiocontrast-induced nephropathy: report of two cases. Cardiovasc Interv Ther. 2011;26:83–8.

    Article  PubMed  Google Scholar 

  4. Saleh L, Juneman E, Movahed MR. The use of gadolinium in patients with contrast allergy or renal failure requiring coronary angiography, coronary intervention, or vascular procedure. Catheter Cardiovasc Interv. 2011;78:747–54.

    Article  PubMed  Google Scholar 

  5. Greenberger PA, Patterson R. The prevention of immediate generalized reactions to radiocontrast media in high-risk patients. J Allergy Clin Immunol. 1991;87:867–72.

    Article  PubMed  CAS  Google Scholar 

  6. Collins MS, Hunt CH, Hartman RP. Use of IV epinephrine for treatment of patients with contrast reactions: lessons learned from a 5-year experience. AJR Am J Roentgenol. 2009;192:455–61.

    Article  PubMed  Google Scholar 

  7. Kim SH, Lee SH, Lee SM, Kang HR, Park HW, Kim SS, et al. Outcomes of premedication for non-ionic radio-contrast media hypersensitivity reactions in Korea. Eur J Radiol. 2011;80:363–7.

    Article  PubMed  Google Scholar 

  8. Agardh CD, Arner B, Ekholm S, Boijsen E. Desensitisation as a means of preventing untoward reactions to ionic contrast media. Acta Radiol Diagn (Stockh). 1983;24:235–9.

    PubMed  CAS  Google Scholar 

  9. Jaarsma C, Leiner T, Bekkers SC, Crijns HJ, Wildberger JE, Nagel E, et al. Diagnostic performance of noninvasive myocardial perfusion imaging using single-photon emission computed tomography, cardiac magnetic resonance, and positron emission tomography imaging for the detection of obstructive coronary artery disease: a meta-analysis. J Am Coll Cardiol. 2012;59:1719–28.

    Article  PubMed  Google Scholar 

  10. Sakuma H, Ichikawa Y, Chino S, Hirano T, Makino K, Takeda K. Detection of coronary artery stenosis with whole-heart coronary magnetic resonance angiography. J Am Coll Cardiol. 2006;48:1946–50.

    Article  PubMed  Google Scholar 

  11. Stahli BE, Bonassin F, Goetti R, Kuest SM, Frank M, Altwegg LA, et al. Coronary computed tomography angiography indicates complexity of percutaneous coronary interventions. J Invasive Cardiol. 2012;24:196–201.

    PubMed  CAS  Google Scholar 

  12. Boyle AJ, Chan M, Dib J, Resar J. Catheter-induced coronary artery dissection: risk factors, prevention and management. J Invasive Cardiol. 2006;18:500–3.

    PubMed  Google Scholar 

  13. Fazel R, Krumholz HM, Wang Y, Ross JS, Chen J, Ting HH, et al. Exposure to low-dose ionizing radiation from medical imaging procedures. N Engl J Med. 2009;361:849–57.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  14. Husmann L, Valenta I, Gaemperli O, Adda O, Treyer V, Wyss CA, et al. Feasibility of low-dose coronary CT angiography: first experience with prospective ECG-gating. Eur Heart J. 2008;29:191–7.

    Article  PubMed  Google Scholar 

  15. Gaemperli O, Bengel FM, Kaufmann PA. Cardiac hybrid imaging. Eur Heart J. 2011;32:2100–8.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

Dr Sumitsuji has received honoraria from Abbott Vascular, Boston Scientific, Terumo, Volcano and Ziosoftware.

Author information

Authors and Affiliations

  1. Department of Advanced Cardiovascular Therapeutics, Osaka University Graduate School of Medicine, 2-2 Yamada-oka Suita, Osaka, 565-0871, Japan

    Patrick T. Siegrist, Satoru Sumitsuji, Masahiro Kumada, Hideaki Kaneda, Kouichi Tachibana & Shinsuke Nanto

Authors
  1. Patrick T. Siegrist
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Satoru Sumitsuji
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Masahiro Kumada
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hideaki Kaneda
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kouichi Tachibana
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Shinsuke Nanto
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Satoru Sumitsuji.

Electronic supplementary material

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Siegrist, P.T., Sumitsuji, S., Kumada, M. et al. Contrast-free diagnosis and treatment of coronary artery disease guided by integrated cardiac imaging: concept and first clinical experience. Cardiovasc Interv and Ther 31, 51–55 (2016). https://doi.org/10.1007/s12928-015-0315-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12928-015-0315-7

Keywords

Search

Navigation