Pulmonary angiography with iopamidol: patient comfort, image quality, and hemodynamics.
The choice of a contrast agent for pulmonary angiography has important implications for patient comfort, image quality, and perhaps the safety of the procedure, particularly for "high-risk" patients. In a prospective study the nonionic, low-osmolality agent iopamidol eliminated the problem of image degradation due to coughing, and patients showed excellent tolerance for it. However, pressure measurements obtained within 3-5 minutes of injection of iopamidol and diatrizoate sodium meglumine 76% showed no significant difference in the hemodynamic effects of the two contrast agents, either for normotensive or for pulmonary hypertensive patients. Contrary to a common presumption, pulmonary hypertension by itself did not appear to increase the risk of pulmonary angiography. The theoretic presumption of greater hemodynamic stability with low-osmolality contrast agents was not clinically evident in this trial with iopamidol. At present, enhanced patient comfort and improved image quality remain the only confirmed bases for choosing this contrast agent for pulmonary angiography.
Saeed
M
M
Department of Radiology, Duke University Medical Center, Durham, NC 27710.
Braun
S D
SD
Cohan
R H
RH
Sussman
S K
SK
Illescas
F F
FF
Perlmutt
L M
LM
Newman
G E
GE
Dunnick
N R
NR
D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D003973:Diatrizoate / Q000009:adverse effects; D005260:Female; D006801:Humans; D007479:Iopamidol / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011651:Pulmonary Artery / Q000000981:diagnostic imaging*; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging; D011859:Radiography
D003973:Diatrizoate; D007479:Iopamidol