Reducing gadolinium deposition for patients being investigated for acute stroke

N. Menon, T. Latham, S. Shah, K. Ng, S. Kelavkar, R. Nusrat, S. Rashmi, D. Ngo, I. Haq, P. Guyler, Iris Grunwald

    Research output: Contribution to journalConference articlepeer-review

    Abstract

    Background and aims: Gadolinium-Based Contrast Agents (GBCA) are used intravenously to provide additional information in
    magnetic resonance imaging (MRI) or magnetic resonance angiography (MRA). Current advice recommends that health care professionals should reassess the necessity of repetitive GBCA in established treatment protocols. Our aim was to assess our use of GBCA, identify patient groups and to change protocols to minimise patient GBCA exposure.Method. Two groups of patients were identified: 1. Patients with diagnosis of stroke or TIA requiring extracranial/intracranial imaging. 2. Patients with possible stroke/stroke mimics requiring imaging diagnosis. In February-April 2016, we evaluated all admitted patients and the number of MRA’s performed.On this
    basis, we amended our protocol restricting MRA use and performing alternative investigations as appropriate.
    Results:
    Table 1
    Total no of patients admitted to the unit over 3months in the 1st cycle 214
    Total numbers of GBCA MRA”s 55
    Number of Stroke and TIA patient ( group1 ) 46
    Number of Miscellaneous neurology diagnosis ( Group 2) 9
    Table 2
    Total no of patient admitted to the unit over 3 months in the 2nd cycle 215
    Total number of GBCA MRA”s 16
    Number of stroke / TIA patients ( Group 1) 12
    Number of Miscellaneous neurology diagnosis (Group 2) 4
    Conclusion: Simple protocol changes reduced the number of MRA performed by 82 % and could be replicated across Europe in other stroke units.
    Use of GBCA can be reduced without compromising rapid investigation and patient care.
    No additional finances and resources were required to implement this change.
    Original languageEnglish
    Article numberP153
    Pages (from-to)83
    Number of pages1
    JournalCerebrovascular Diseases
    Volume43
    Issue numbersuppl 1
    DOIs
    Publication statusPublished - Jul 2017
    Event26th European Stroke Conference - Berlin, Germany
    Duration: 24 May 201726 May 2017

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