Incompatibility of Hexabrix and papaverine in peripheral arteriography

A case is reported in which a previously patent artery became temporarily occluded during angiography. The authors believe it happened because of incompatibility of the contrast agent ioxaglate (Hexabrix) and papaverine. Extreme caution is recommended whenever a new low-osmolality contrast agent is used in conjunction with a pharmacoangiographic agent.     

Simplified peripheral arteriography

Demonstration of both iliofemoral arteries and their peripheral run-off is usually performed either by the translumbar approach, or by placing a pigtail catheter at the aortic bifurcation. A modified version of the old retrograde pressure method, simply using a cannula in one femoral artery, is described. There was considerable saving in materials, personnel and time. This method may once again be the method of choice in a busy radiology department.     

Intraarterial analgesia in peripheral arteriography.

A pilot study involving 36 patients was undertaken to test the efficacy of combining 1% lidocaine with 60% methylglucamine iothalamate for relief of the severe burning pain often experienced during peripheral arteriography. Of 24 patients premedicated with meperidine hydrochloride and promethazine hydrochloride, 12 received lidocaine with the contrast medium and 12 did not. The remaining 12 patients were premedicated with diazepam and received lidocaine with the contrast material. By both subjective and objective criteria, those patients receiving lidocaine in the intraarterial injection of contrast medium suffered less pain. Optimum results were achieved for the lidocaine group receiving analgesic premedication. No adverse reactions attributable to the lidocaine were encountered. Subsequent to completion of the pilot study, more than 300 patients have been studied with similar impressive results of pain relief and safety.     

A comparison of hexabrix and Renografin 60 in peripheral arteriography

Fifty-one patients were analyzed after a randomized double-blind study comparing Hexabrix and Renografin 60 in peripheral arteriography. The arteriographic studies and the volumes of contrast material used in both groups were similar. Hexabrix caused significantly less pain and discomfort than Renografin 60, and the diagnostic quality of the radiographs was comparable. A slightly higher incidence of minor side effects was noted in the Hexabrix group, mostly nausea and vomiting and urinary retention.     

Reactional hyperaemia and peripheral arteriography (author's transl)]

Reactional hyperaemia is a technique for functional study of the peripheral arterial circulation which may be applied to arteriography. It represents the maximum point on the scale of modifiers of function which may be used in peripheral arteriography. It opens the way to interesting comparison between peripheral arteriography and the various functional studies which may be employed in peripheral vascular pathology.     

The utility of digital subtraction arteriography in peripheral vascular disease

Digital subtraction angiography (DSA), whether used in conjunction with intravenous or intraarterial injection techniques, has an established role in evaluation of peripheral vascular disease. Use of DSA can reduce the time, cost, and patient discomfort of the standard arteriographic study. While it is limited by field size and patient cooperation in some instances, the utility of noninvasive imaging using intravenous DSA and the added anatomic detail of intraarterial DSA for roadmapping and delineation of small distal vessels provide the basis for future integration of standard arteriographic and DSA methods in assessment of peripheral vascular disease.