[Electron microscopic comparison of the antithrombotic potential of 2 low osmolality iodine contrast media in percutaneous transluminal coronary angioplasty].
The antithrombogenic potentials of two low osmolality iodine contrast media, ioxaglate (Iox), an ionic product, and iopamidol (Iop), a non-ionic product, were compared in a multicentre, randomised, double-blind study in 64 patients undergoing percutaneous transluminal coronary angioplasty (PTCA) by scanning electron microscopy for the presence of thrombotic material on the guiding catheter (GC) and guide wires (GW). The procedure was strictly standardised: stable angina, type A coronary lesions; aspirin administration (at least 300 mg the day before and on the day of angioplasty); heparinisation (10000 IU at the beginning of the procedure); same GCs (Marathon Baxter 8F), same GWs (Veriflex USCI 0.014). The tips of the catheters and guide wires were scanned by an electronic microscope in a double-blind protocol. The scores for the number of erythrocytes (RBCs), platelets (PLs) and constituted thrombi (THi) were; thickness scored from 0 to 3, the % surface covered and an index of volume combining these two parameters. The clinical and angiographic characteristics of the 2 groups were strictly comparable. The time that the GCs and GWs were in the circulation were 30.0 +/- 2.3 vs 32.6 +/- 3.0 minutes for the former, and 18.6 +/- 1.8 vs 17.1 +/- 1.4 minutes for the later in the Iox and Iop groups, respectively (NS). An angiographic filling defect was not observed in any of the patients in the Iox group and in 4 patients (13%) in the Iop group (NS). The number of thrombotic elements observed on the GCs (RBCs, PLs, THi) was negligible in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)
Lefèvre
T
T
UCVI, clinique Henry-Hartmann, Neuilly-sur-Seine.
Bernard
A
A
Bertrand
M
M
Lablanche
J M
JM
Cequier
A
A
Espuglas
E
E
Gayet
J L
JL
Gosselin
G
G
Bonan
R
R
D015906:Angioplasty, Balloon, Coronary; D001777:Blood Coagulation / Q000187:drug effects*; D003287:Contrast Media / Q000494:pharmacology*; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000473:pathology / Q000628:therapy*; D006801:Humans; D007479:Iopamidol / Q000494:pharmacology; D007485:Ioxaglic Acid / Q000494:pharmacology; D008855:Microscopy, Electron, Scanning; D009994:Osmolar Concentration
D003287:Contrast Media; D007479:Iopamidol; D007485:Ioxaglic Acid
Comparison en microscopie électronique du potentiel antithrombogène de deux produits de contraste iodés de basse osmolalité au cours de l'angioplastie coronaire transluminale percutanée.