Role of low-osmolality contrast media in thromboembolic complications: scanning electron microscopy study.
Numerous in vitro studies have found that clot formation may occur when blood is mixed directly with nonionic low-osmolality contrast media during angiographic procedures because of activation of hemostasis in the catheter; ionic contrast media, on the other hand, inhibit clot formation. Thirty patients were injected with low-osmolality contrast media--15 with ioxaglate, an ionic dimer, and 15 with iopamidol, a nonionic monomer. The inner wall of the angiographic catheter was studied with electron microscopy after selective catheterization of supraaortic vessels. Clot formation of various extent was observed in nine (60%) of the patients administered iopamidol. No coagulation process was found in the catheters of the patients administered ioxaglate. Results indicate that nonionic, low-osmolality contrast media may play a role in the formation of thromboembolisms.
Casalini
E
E
Department of Radiology, Istituti Clinici di Perfezionamento, Milan, Italy.
D000368:Aged; D000792:Angiography; D001777:Blood Coagulation / Q000187:drug effects; D002404:Catheterization / Q000295:instrumentation; D005260:Female; D006801:Humans; D007479:Iopamidol / Q000009:adverse effects*; D007485:Ioxaglic Acid / Q000009:adverse effects*; D008297:Male; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D009994:Osmolar Concentration; D013923:Thromboembolism / Q000139:chemically induced* / Q000473:pathology
D007479:Iopamidol; D007485:Ioxaglic Acid