-ray coronary angiography (CAG) is an indispensable examination technique for the diagnosis of coronary artery disease and for determination of therapeutic strategies. However, an anaphylactic reaction to the iodinated contrast media can be life-threatening. Gadolinium-based contrast media have been developed to improve the quality of magnetic resonance imaging (MRI) and are considered to be safer and less nephrotoxic than the iodinated agents. It has been recently reported that computed tomography (CT) and digital subtraction angiography (DSA) using gadolinium can provide images of largeand medium-sized vessels of acceptable quality in patients with allergy to iodinated media. 1-5 However, only a few studies of using gadolinium for CAG have been reported and only its safety in patients with renal insufficiency has been discussed. [6][7][8] We report successful CAG using gadodiamide hydrate (Gd DTPA-BMA; Omniscan ® Nycomed, Oslo. Norway) in 3 patients with allergy to iodinated contrast media. Written informed consent for the use of the contrast media was obtained from all patients. Case Reports Case 1A 70-year-old woman (52 kg) with a history of thyroidectomy for thyroid cancer and allergic reaction to iodinated contrast media was admitted to hospital after presenting with chest pain and dyspnea. Electrocardiography showed ST-segment elevation in leads V1-3 leads and T wave inversion in V2-4, and echocardiography showed hypokinesis in the apico-anteroseptal wall of the left ventricle. After sublingual administration of nitroglycerin, her symptoms Circulation Journal Vol. 69, April 2005 and the electrocardiographic findings improved. CAG was performed using 40 ml of undiluted Gd DTPA-BMA in a total of 7 injections because she had a previous, unspecified history of shock as a severe allergic reaction to treatment with an iodinated disinfectant. CAG revealed no significant stenoses in the major coronary arteries (Fig 1) and so we considered her anginal attack might be coronary arterial vasospasm in the left anterior descending artery. Case 2A 71-year-old man (68 kg) with gastric cancer and abdominal aortic aneurysm was admitted to hospital for gastric resection and artificial vessel replacement. He had a history of acute myocardial infarction at 63 years of age and an allergic reaction to an unspecified iodinated contrast media during abdominal CT performed when he was 60 years of age. 99m Tc-tetrofosmin myocardial scintigraphy on admission showed multivessel disease in his coronary arteries, so he underwent preoperative CAG using 40 ml of undiluted Gd DTPA-BMA in a total of 5 injections. Digital subtraction post-processing showed significant stenoses in the mid right coronary artery (segment 2: 75% stenosis), in the circumflex artery (segment 11: 75%, segment 13: 90%), and total occlusions in the distal right coronary artery (segment 4, postero-lateral branch) and the mid left anterior descending artery (segment 7) with contralateral collateral feedings (Fig 2). He underwent coronary artery bypass grafting be...