Gadolinium as an alternative contrast medium in endovascular embolization of a dural arteriovenous fistula patient with severe iodine allergy

Gadolinium-based contrast agents can be alternative for patients with contraindications to iodinated contrast media. However, intra-arterial gadolinium-based contrast agent administration for angiography presents technical challenges due to dosage restrictions and suboptimal image quality, particularly in complex cerebrovascular interventions. In this context, we report the successful embolization of a complex dural arteriovenous fistula using gadolinium-based contrast agents, achieved through optimized DSA imaging parameters and strategic contrast dilution.