Iohexol, ioxaglate and iopamidol in coronary angiography. A double-blind comparative study of 300 patients

A randomized, double-blind study was carried out in 300 consecutive coronary angiography examinations to investigate the clinical safety of three low osmolar contrast media, iohexol 300, ioxaglate 320 and iopamidol 300, and the electrocardiographic changes that occurred with them. The ECG from electrode V5/V6 or AVF and intra-arterial pressure were monitored continuously, and recorded before and after the first contrast injections into the left and right coronary arteries. Of the variables tested, no statistically significant changes occurred in systolic arterial pressure, PR interval or ventricular extrasystole. The QT interval increased in the ioxaglate group (p = 0.001). Heart rate decreased in all groups, but slightly less in the ioxaglate group than in the iopamidol group (p = 0.02). The ST segment depression (mean 0.67m) was more marked in the ioxaglate group than in the other treatment groups (p = 0.0001) during right coronary angiography. The same characteristics, but less marked, were observed during left coronary angiography, the ioxaglate group (mean 0.251mm) differing from the iopamidol group (mean 0.050mm) (p = 0.04). No significant difference in severe adverse reactions were detected between these groups (ioxaglate 1, iopamidol 1). Ioxaglate produced mild side effects (nausea, vomitus, urticaria) in 16% of the patients, the other two contrast agents producing side effects in 1%.     

Spinal angiography with Iohexol

Summary Iohexol 300 was used for 55 selective spinal angiograms in 50 patients; all were of good quality. There was no significant change in vital signs during the angiographic procedure in any case. Two patients with spinal dural arteriovenous fistula draining into a coronal venous plexus developed transient subjective slight increase in their disability during the immediate post-angiographic period. Eight cases embolised at the time of angiography showed improvement in their neurological deficits within 24 h of the study. The other patients were unaffected by the procedure. Iohexol 300 is a very suitable contrast medium for spinal angiography.     

Iohexol versus iopamidol for cervical myelography: a randomised double blind study

A randomised double blind trial of iohexol and iopamidol in cervical myelography by both lumbar puncture and direct puncture techniques is reported in one hundred consecutive patients. All patients had EEG examination before and 6-8 h after the myelogram and for each a questionnaire regarding adverse reactions was completed at set intervals. The side effects, radiographic quality of the examination and production of sharp wave activity on EEG were equivalent in the iohexol and iopamidol series. Contrary to previous reports, we consider that iohexol and iopamidol are equally acceptable for all forms of myelography.     

Iohexol and ioxaglate in peripheral angiography

A double-blind, cross-over trial of the non-ionic, low-osmolar contrast medium iohexol (Omnipaque) and the ionic, low-osmolar medium ioxaglate (Hexabrix) at concentrations of 300 mg I/ml was carried out in 107 consecutive patients with arterial insufficiency of the lower limbs. The purpose of the study was to observe possible 'carry-over' effects from any of the contrast media, and to evaluate patient discomfort such as pain, adverse reactions, or effect on peripheral blood pressure. No carry-over effect was seen. Ioxaglate caused less injection pain and heat sensations than iohexol, and showed less effect on the systemic blood pressure.     

Iohexol and meglumine iothalamate in shoulder arthrography. A double-blind investigation

The first clinical experience with the new contrast medium, iohexol, in shoulder arthrography is reported. A double-blind comparison of iohexol and meglumine iothalamate, a conventional medium in standard use for arthrography, was carried out in a consecutive series of 60 adult patients forming two groups of 30 subjects each. No difference in the radiographic quality was seen immediately after contrast injection but in exposures at 20 min iohexol gave a significantly better arthrographic quality. Practically no adverse effects occurred during the examinations. Although minor side effects were numerous in both groups during the two days following arthrography, they were somewhat more frequent in patients given iothalamate.     

A comparison of Iohexol and Conray-60 in peripheral angiography

A double-blind clinical trial was performed in 61 adults in an attempt to compare the safety and efficacy of an ionic with a nonionic contrast agent in peripheral angiography. Objective clinical (vital signs) and laboratory factors (complete blood count, serum electrolytes, serum chemistry, urinalysis, and urine chemistry) were monitored before, during, and after the examination on each patient. There was no statistically significant difference in pre- and posttest laboratory and clinical parameters between those patients who received ionic and those who received nonionic contrast material. Data also were collected to evaluate pain and radiographic quality. The most striking finding was the marked diminution of perceived pain in those patients who received nonionic contrast material compared with those who did not. The data suggest that nonionic contrast agents are at least as safe as the ionic agents currently in use and produce an examination of equal quality with considerably less patient discomfort.     

Iohexol compared to Urografin Meglumine in cerebral angiography

Summary In a double blin cross-over study the non ionic, water soluble contrast medium iohexol has been compared to Urografin Meglumine by angiography in common carotid artery and vertebral artery. More subjective adverse effects were generally seen with Urografin than with iohexol and statistically there were significantly less changes in heart rate after iohexol but no significant changes in the intra-arterial recorded blood pressure.     

Omnipaque and Urografin in left ventriculography and coronary arteriography. A randomised, double blind study

In order to compare tolerability and radiographic properties of Omnipaque (iohexol) 350 mg I/ml and Urografin (sodium meglumine diatrizoate) 76% (370 mg I/ml) in left ventriculography and coronary arteriography, a randomised, double-blind parallel study was conducted. ECG, heart rate, blood pressure, cardiac output, oxygen saturation, CK-MB, adverse reactions and opacification were recorded. Twenty-five patients received Omnipaque and 24 Urografin and all patients were included in the final material. Omnipaque was found to have less influence on haemodynamics than Urografin. Few adverse reactions were encountered in the entire study, but fewer after injections of Omnipaque than after Urografin. Equally good opacification was demonstrated for both media. Omnipaque was found well suited for cardioangiography and superior to standard ionic media.     

High dose urography in patients with renal failure. A double blind investigation of iohexol and metrizoate

The new non-ionic contrast medium iohexol 350 mg I/ml was compared with the ionic contrast medium metrizoate 350 mg I/ml in a double blind, two-group urographic study performed on 20 patients with stable, impaired renal function. A dose of contrast medium of 500 mg I/kg body weight was given to each patient. Iohexol resulted in significantly fewer subjective adverse reactions than metrizoate. A similar image quality was obtained with the two contrast media. No clinically significant difference existed between the two contrast media with respect to influence on blood pressure, pulse or clinical chemical parameters. A tendency to deterioration of renal function after urography was found in both groups, but no difference of statistical significance existed between the two contrast media with respect to possible nephrotoxicity. Inadequate hydration may have been partly responsible for the nephrotoxic effect of the urographic procedure.     

Clinical trial of Iohexol vs. Conray 60 for cerebral angiography

Iohexol, a new nonionic contrast agent, and Conray 60 were compared in a double-blind clinical trial of 60 patients for safety, imaging effectiveness, and patient discomfort in cerebral angiography. There was no significant difference between the two agents in physiologic changes, film quality, or incidence of adverse effects in the 60 patients. One patient in the iohexol group suffered a cardiac arrest, which was clinically due to septic shock and was probably the result of inadvertent contamination of the iohexol used for test injections in this case. Bacterial growth can be supported in iohexol under certain circumstances, due to the lack of preservatives in this contrast material. The patients in the iohexol group experienced significantly less discomfort than the Conray 60 group. Iohexol is a safe, effective contrast agent when handled properly and causes less discomfort to patients than Conray 60.     

Iopentol compared with iohexol in carotid angiography. A double blind crossover test of a new non-ionic contrast medium

A randomized double blind crossover test with iohexol and the new non-ionic contrast medium iopentol in 12 patients undergoing carotid angiography showed no difference in tolerability, EEG, ECG, neurologic status or image quality. Iopentol seems to be well suited for cerebral angiography.     

Technique of coronary angiography.

A new manufacturing process and new shapes of the left and right catheters for coronary angiography by the transfemoral route increase the safety of the examination by reducing the time and avoiding the risks involved in catheter occlusion of the arteries. The simultaneous filling of the sinus and the whole coronary artery from its origin increases the anatomic information. Pressure-monitoring is unnecessary.     

Clinical testing of Iohexol,Conray meglumine and Amipaque in cerebral angiography

Summary Iohexol 300 mg I/ml, Conray meglumine 282 mg I/ml and Amipaque 300 mg I/ml have been compared in a randomized double-blind cross over study in which one injection of Iohexol 300 mg I/ml and Conray meglumine 282 mg I/ml was made in the same artery (common and internal carotid artery) of the same patient, and one injection of Iohexol 300 mg I/ml and Amipaque 300 mg I/ml was made in another artery (external carotid artery and vertebral artery). All together 63 cerebral artery branches were examined in 27 patients, who served as their own controls. The effect of the contrast injections on the intraarterial blood pressure, pulse rate, ECG, circulatory rate and the patients' reactions were recorded under standardized conditions. The quality of the film was also evaluated. No significant difference was found in the cardiovascular effects after the injection of Iohexol or Conray meglumine into the common carotid or internal carotid. There was significantly less pain and sensation of warmth after the injection of Iohexol than after Conray meglumine 282. In the vertebral and the external carotid arteries, where a comparison between Iohexol and Amipaque was carried out, it was found that no significant difference in the cardiovascular effects occurred. There was less sensation of warmth after the injection of Amipaque into the vertebral artery than was caused by Iohexol. The degree of discomfort in form of pain reaction was the same for the two media, when these reactions occured. No serious side effects were observed.Read at the Annual Meeting of the Scandinavian Society of Neuroradiology, August 1981     

Iohexol vs. ioxaglate in lower extremity angiography: a comparitive randomized double-blind study in 80 patients

The aim of this study was to detect clinically relevant differences between iohexol 300 mgI/ml and ioxaglate 320 mgI/ml in lower extremity arteriography. In this randomized double-blind study, 40 patients were examined with iohexol and 40 patients with ioxaglate. Adverse events were evaluated by recording the time of onset and the duration of possible adverse events: during or immediately following the contrast medium injections, after 6 h, and after 24 h following these injections. Heat and pain were scored on visual analog scales. The amount of contrast medium and possible thromboembolic complications were noted. Image quality was evaluated. There were no significant differences in the total amounts of contrast agent adminstered (ioxaglate mean 121.5 ml vs. iohexol 125.1 ml), scores for heat (ioxaglate mean 6.1 vs. iohexol 6.1) and pain (both agents mean 2.35). Nausea/vomiting was noticed significantly more frequently with ioxaglate (ioxaglate seven patients vs. iohexol one patient (χ², P < 0.05)). Thromboembolic complications were not detected. Opacification of vessels was optimal in all patients. No clues were found indicating that one of the agents was better tolerated 6–24 h after the procedure than the other. Nausea/vomiting occurred significantly more frequent with ioxaglate; no further clinically relevant differences were detected.     

Cerebral angiography with the non-ionic water-soluble contrast medium Iohexol and Meglumine-Ca-Metrizoate

Summary A double blind study was carried out to evaluate safety, tolerability and visualization quality of the non-ionic contrast medium Iohexol compared to Meglumine-Ca-Metrizoate (Isopaque Cerebral) for cerebral angiography. The two contrast media were found equal in most respects. A slight increase in systolic blood pressure following Meglumine-Ca-Metrizoate injections and a slight decrease in diastolic blood pressure following Iohexol were statistically significant. Tachycardia following injections of Meglumine-Ca-Metrizoate in the aortic arch was also significant and may indicate more discomfort from this medium, although no difference was found in patient interviews. The changes in blood pressure and heart rate were small and of no clinical importance.     

A method of coronary MR angiography

Procedures for the in vivo detection of coronary (and pulmonary) vessels using MR angiographic techniques were investigated. The most successful technique used gradient-recalled thin slice acquisitions that were gated to the cardiac cycle. The resulting data sets consist of three spatial dimensions and one time dimension. Acquisition of four dimensions of data proved necessary to obtain useful images of small vessels located on the moving myocardium.