Gadolinium to the rescue for mechanical thrombectomy in acute ischemic stroke

Shailesh Male, Tapan Mehta, Huseyin Tore, Coridon Quinn, Andrew W. Grande, Ramachandra P. Tummala, Bharathi D. Jagadeesan

Research output: Contribution to journalArticlepeer-review


Introduction: Mechanical thrombectomy in the setting of acute ischemic stroke (AIS) requires cerebral digital subtraction angiography (DSA), typically performed with iodinated contrast medium. We present a case of emergent cerebral DSA and mechanical thrombectomy using gadolinium-based contrast for cerebral DSA in a patient with a history of anaphylaxis to iodinated contrast agents (ICs). Case report: A 72-year-old man developed left ventricle assist device thrombus while on anticoagulation. During hospitalization he suffered right middle cerebral artery occlusion with a National Institutes of Health stroke scale score of 10. He had a history of anaphylaxis and the advanced directives revealed do not resuscitate/do not intubate status. We performed an emergent DSA as part of thrombectomy procedure using gadolinium-based contrast mixed in 1:1 proportion with normal saline. The images obtained were of adequate quality and the patient underwent successful thrombectomy with modified thrombolysis in cerebral infarction 2B recanalization. Conclusion: Gadolinium-based contrast agents could be effective alternatives for cerebral DSA in patients undergoing mechanical thrombectomy for AIS who have a history of anaphylactic reaction to ICs.

Original languageEnglish (US)
Pages (from-to)301-304
Number of pages4
JournalInterventional Neuroradiology
Issue number3
StatePublished - Jun 1 2019


  • Gadolinium
  • allergy
  • angiogram
  • contrast
  • stroke
  • thrombectomy

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