Influence of a non-ionic radiography contrast medium on the microcirculation.
PURPOSE, MATERIAL AND METHODS: Microcirculatory disturbances may be responsible for some of the adverse effects induced by contrast media. The influence of iopromide 370 (Ultravist) on cutaneous microcirculation was therefore investigated in 15 patients in a prospective study. Twenty ml of iopromide and 20 ml 0.9% NaCl were injected as reference in the subclavian artery at the beginning of a diagnostic coronary angiography. Erythrocyte velocity was measured in ipsilateral nailfold capillaries at the beginning of, during, and after the injection continuously up to 6 min after injection.


RESULTS
On average, 30 s after injection of contrast medium, erythrocyte velocity decreased significantly by 51.3% (p<0.0001) and remained reduced up to 120 s. This reaction was observed in 14 out of 15 patients. Three patients showed a temporary cessation of capillary blood flow.


CONCLUSIONS
The adverse effects sometimes seen during coronary angiography can be explained if similar contrast medium induced microcirculatory disturbances in the myocardial vasculature.
Bach
R
R
Cardiac Out-Patient Centre, Dresden, University Hospital of Saarland, Germany.
Jung
F
F
Scheller
B
B
Hummel
B
B
Ozbek
C
C
Spitzer
S
S
Schieffer
H
H
D000328:Adult; D000368:Aged; D002196:Capillaries / Q000187:drug effects; D003287:Contrast Media / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007472:Iohexol / Q000009:adverse effects / Q000031:analogs & derivatives*; D008297:Male; D008833:Microcirculation / Q000187:drug effects*; D008875:Middle Aged; D011446:Prospective Studies; D012867:Skin / Q000098:blood supply
D003287:Contrast Media; D007472:Iohexol; C038192:iopromide