Ultrasound and fluoroscopic-guided angioplasty over the aortic bifurcation in a patient with previous severe reaction to contrast medium.

摘要

PURPOSE: To describe a case of ultrasound and fluoroscopic-guided angioplasty necessitated by a patient history of allergic reaction to contrast medium. CASE REPORT: A 60-year-old man with intermittent right leg claudication had a focal >70% stenosis in the right external iliac artery that was amenable to balloon dilation; however, the patient reported a severe reaction to radiographic contrast medium 10 years previously. Angioplasty was begun with transaortic access to the iliac artery lesion under fluoroscopic guidance only. On-table duplex imaging confirmed the lesion site and reference diameters for balloon selection. The balloon was filled with contrast medium to provide rapid positioning under fluoroscopy. An on-table postangioplasty duplex scan showed improvement in the lumen contour and confirmed a reduction in the peak systolic velocity. At the 1-year follow-up, the patient reports no symptoms referable to the treated segment. CONCLUSIONS: The combination of ultrasound and fluoroscopy facilitated quick and efficient balloon dilation of an isolated iliac lesion without the use of any contrast medium.