Bismuth Chelate-Mediated Digital Subtraction Angiography

Digital subtraction angiography (DSA) is considered the “gold standard” for the diagnosis of vascular diseases. However, the contrast agents used in DSA are limited to iodine-based small molecules, which are unsuitable for patients with contraindications. Here, we propose iodine-free DSA utilizing a bismuth chelate, Bi-DTPA Dimeglumine, for vascular visualization for the first time. Bi-DTPA Dimeglumine possesses a simple synthesis process without the need for purification, large-scale production ability (over 200 g in the lab), superior X-ray imaging capability, renal clearance capacity, and good biocompatibility. Bi-DTPA-enhanced DSA can clearly display the arteries of the rabbit's head and lower limbs, with a minimum vascular resolution of 0.5 mm. The displayed integrity of terminal vessels by Bi-DTPA-enhanced DSA is superior to that of iopromide-enhanced DSA. In a rabbit model of thrombotic disease, Bi-DTPA Dimeglumine-enhanced DSA enables the detection of embolism and subsequent reevaluation of vascular conditions after recanalization therapy. Our proposed iodine-free DSA provides a promising and universal approach for diagnosing vascular diseases. This article is protected by copyright. All rights reserved