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     

Amipaque in coeliac angiography

Coeliac angiography was performed in 12 patients using Amipaque 370 mg I/ml or Isopaque 370 mg I/ml. No significant biochemical alterations were found in serum. Amipaque improved the demonstration of small vessels in the liver and in the head of the pancreas. Amipaque caused no discomfort contrary to Isopaque, which gave moderate to severe heat during injection.     

Effect of ionic and non-ionic contrast medium on aortic and pulmonary arterial pressure. An angiocardiographic study in rabbits.

Effects in angiocardiography from injections into the right atrium of rabbit hearts of a new, non-ionic contrast medium (Amipaque) were studied and were compared with the effects from injections of an ionic medium (Isopaque Coronar) at a dose of 3 ml/kg rabbit and concentration of 370 mg I/ml. Forty-seven experiments in 11 rabbits are reported. Amipaque produced a significantly (p less than 0.001) smaller increase in pulmonary arterial pressure (29%) than Isopaque Coronar (82%). Simultaneously (within 12 seconds from the beginning of an injection) Amipaque produced an increase in aortic pressure of 21%. About 10-15 seconds later when the contrast media had reached peripheral vessels Amipaque produced a significantly (p less than 0.001) smaller decrease of aortic pressure (12%) than the decrease produced by Isopaque Coronar (40%). The differences found between the two types of contrast media are believed to be related to, among other factors, their different osmolality. The osmolality of Amipaque was about one third of the osmolality of Isopaque Coronar.     

Clinical testing of conray meglumine and Amipaque in cerebral angiography

Summary Amipaque 280 mg I/ml and Conray meglumine 282 mg I/ml have been compared in a double-blind trial in cerebral angiography. Altogether 55 cerebral artery branches have been examined in 21 patients, who served as their own controls. The effect of the contrast injections on the intra-arterial blood pressure, pulse rate, ECG, circulatory rate and the patients' reactions were recorded under standardized conditions. The quality of the films was also evaluated. No signficant difference in the cardiovascular effects of the two contrast media was found. There was a significant difference in favour of Amipaque in the discomfort of the patients—less pain and sensation of warmth. No serious side effects were observed.Read at the Annual Meeting of the Scandinavian Society of Neuroradiology, September 1978     

Antibacterial effects of metrizoate and metrizamide on bacterial growth in vitro.

Urinary pathogens were exposed in vitro to Isopaque and Amipaque in concentrations of 100 mg I/ml and 260 mg I/ml. Both contrast media in the higher concentration had a slight or negligible bacteriostatic effect on some of the test bacteria. No bactericidal effect was detected. Consequently, radiography of the urinary tract with these two media in the concentrations mentioned does not interfere with the culturing of bacteria from urine samples.     

Clinical testing of amipaque for cerebral angiography

Summary Amipaque 280 mg I/ml was compared to Isopaque Cerebral 280 mg I/ml for common carotid injection in twenty patients in a double blind trial. Simple comparison was also performed in examinations with selective external carotid injections. The reaction of the patients to the common carotid injection was mild on the whole but Amipaque caused significantly less discomfort than Isopaque. Selective external carotid injection of Amipaque caused very little discomfort while most patients complained of severe pain when Isopaque was used. No serious side-effect was observed.Read at the Annual Meeting of the Scandinavian Society of Neuroradiology August 31 1977, and at the 7th Congress of the European Society of Neuroradiology September 10 1977     

Clinical testing of omnipaque and amipaque in external carotid and vertebral angiography: randomized double-blind crossover study

Omnipaque, 300 mg l/ml, was compared with Amipaque, 300 mg l/ml, for cerebral angiography. Twelve patients were included in a randomized, double-blind, crossover study. Twenty comparisons were made in the external carotid and 21 in the vertebral artery, Both contrast media caused no or minor changes in blood pressure and heart rate. Good to excellent radiographic visualization of the cerebral arteries was obtained with both agents. The frequency of subjective reactions was almost equal, but the intensity of the reactions was less with Amipaque. No severe reactions were observed. Omnipaque is a more practical nonionic contrast medium than Amipaque because it is delivered in ready-to-use solutions.     

The toxicity of the non-ionic water-soluble contrast media iohexol and metrizamide (Amipaque) in selective vertebral angiography

Summary Selective left vertebral angiography was carried out in 25 rabbits comparing the toxic effects of iohexol and metrizamide (Amipaque). The iodine concentration for iohexol was 280 and 350 mg/ml and for metrizamide 350 mg/ml. Short general convulsions were seen in many of the animals with iohexol in the concentration of 350 mg iodine/ml. Cardiovascular reactions were seen with both contrast media, but were more marked with iohexol than with metrizamide in the concentration of 350 mg iodine/ml. Both iohexol and metrizamide are far less toxic than the ionic contrast medium metrizoate, but metrizamide seems to be less toxic than iohexol in vertebral angiography.     

Comparative double-blind investigation of meglumine metrizoate, metrizamide, and iohexol in carotid angiography

The new nonionic contrast medium iohexol (Omnipaque) was compared with its predecessor metrizamide (Amipaque) and with the conventional ionic medium meglumine metrizoate (Isopaque Cerebral) in carotid angiography using a double-blind crossover technique. The results indicated that iohexol and metrizamide caused less discomfort than the ionic medium. The circulatory effects of the three media were generally mild, and the diagnostic effectiveness was comparable when the iodine concentration was kept in the range of 280-300 mg I/ml.     

Iohexol compared to metrizamide in cervical and thoracic myelography

Summary A randomized double blind study with iohexol (Omnipaque) and metrizamide (Amipaque) in cervical myelography was performed in 50 patients, 29 with iohexol and 21 with metrizamide. The myelographies were performed either with lumbar or with C₁–C₂ puncture in about equal groups, using 300 mg I/ml and 240 mg I/ml of the contrast media respectively. The image quality was equal with both contrast media, excellent in about 4/5 and good in 1/5 of the examinations. Subjective side effects were twice as frequent with metrizamide as with iohexol. The most frequent side effect was headache, occurring in 34% with iohexol and in 67% with metrizamide. Altogether 24% or the patients had EEG changes after iohexol as compared to 47% after metrizamide. All EEG changes were slight dysrythmia-except in three patients with spike activity after metrizamide. These were the only ones with mental reactions as well. It can be concluded that in this trial iohexol was better suited for cervical myelography than metrizamide.     

Randomized double-blind cross-over study of iohexol and Amipaque in cerebral angiography

Iohexol was compared with Amipaque (metrizamide) in a double-blind study in one pair of injections in each of 20 patients referred for routine cerebral angiography. Catheter position, patient position, injection pressure, contrast medium volume, and concentration (300 mg l/ml) were the same in the two injections, with iohexol and Amipaque being used alternately. Except for these two injections iohexol was used throughout. The parameters studied included diagnostic information obtained (quality of the examination), circulation time, and comparison of patient reactions to the pair of injections (e.g., electrocardiogram, heart rate, and subjective reactions). The patients' reactions to the noncomparative part of the examination were evaluated also, and the patients were observed for possible adverse reactions after the examination. No difference could be detected between the two contrast media in this series. No serious adverse reactions occurred.     

Hexabrix (ioxaglate), a new low osmolality contrast agent for lumbar epidural double-catheter venography

Summary Hexabrix (ioxaglate), a new low osmolality contrast agent, has been compared with Télébrix (ioxitalamate) in a series of 50 lumbar epidural venograms. The intensity of the pain and heat sensation experienced by the patient was significantly lower following the injection of Hexabrix. For this reason Hexabrix may be considered the contrast medium of choice for epidural venography. In 15 additional cases Hexabrix was compared with Amipaque (metrizamide) in the same iodine concentration (320 mg/ml). In these patients hardly any difference in pain and heat sensation was observed after the injection of both contrast agents. Frequently only a slight feeling of warmth was noticed. A minimal sensation of pain was occasionally observed to the same degree with both contrast agents.     

对比剂浓度及剂量对MSCT髂静脉成像的影响

目的:探讨不同对比剂浓度及注射剂量对MSCT髂静脉成像质量的影响.方法:120例受检者按不同对比剂浓度及注射剂量随机分成6组,Ⅰ组(300 mg Ⅰ/ml,100 ml),Ⅱ组(150 mg Ⅰ/ml,100 ml),Ⅲ a组(100 mg Ⅰ/ml,150 ml),Ⅲb组(100mg Ⅰ/ml,100ml),Ⅲc组(...     

The toxicity of the non-ionic watersoluble contrast medium metrizamide (Amipaque) in selective vertebral angiography

Summary Selective left vertebral angiography was carried out in 21 rabbits comparing the toxic effects of meglumine iothalamate (Conray meglumine), meglumine metrizoate (Isopaque Cerebral) and metrizamide (Amipaque). The iodine concentration for all 3 media was 280 mg/ml. General convulsions were seen in many of the animals with all 3 media. The convulsions occurred at higher doses and were milder with metrizamide than with the 2 other contrast agents. Bradycardia was also seen with all 3 media and there was no statistical significant difference between them in this respect. The mortality was approximately 50% with both meglumine iothalamate and meglumine metrizoate, while no animals died following angiography with metrizamide.     

Herniography: comparison of morbidity and image quality after use of high and low osmolality contrast media

The morbidity and image quality after administration of three different contrast media were compared in 229 patients referred for herniography. Sixty patients received metrizoate 150 mg I/ml, 92 received metrizoate 200 mg I/ml, and 77 patients, ioxaglate 200 mg I/ml. Patient discomfort was single-blindedly assessed based on an arbitrary verbal rating scale. The number of patients with pain increased with the osmolality of the contrast media. Metrizoate 200 induced pain in 57% of the patients, metrizoate caused pain in 39%, and ioxaglate 200 in 18%. Hernia patients who received metrizoate 200 had pain significantly more often (72%) than patients without hernia (45%). Seven patients, predominantly young men, had a vasovagal reaction associated with the administration of contrast media. The image quality was sufficient after all injections of 200 mg I/ml. The results indicate that low osmolality contrast media with an iodine concentration of about 200 mg I/ml are well suited for herniography.     

Contrast agents for myelography: clinical and radiological evaluation of Amipaque and Pantopaque.

The diagnostic quality and side effects of Amipaque and Pantopaque as myelographic contrast agents were compared prospectively using the identical protocol in 167 cases (117 Amipaque, 50 Pantopaque). Good ratings were attained in 74% of Amipaque and 76% of Pantopaque examinations. Demonstration of nerve rootlets in the cauda equina and filling of lumbar root sleeves were superior with Amipaque. Amipaque more easily demonstrated the high posterior cervical subarachnoid space and the anterior and posterior margins of the cervical spinal cord. The incidence of postmyelographic headache was 38% with Amipaque and 32% with Pantopaque. Nausea and vomiting were more common with Amipaque. Two patients experienced grand mal seizures after examination sith Amipaque.     

Amipaque myelography without late adhesive arachnoid changes

Summary Sixty-three myelographies were performed with Amipaque. Remyelography after an interval of longer than 2 months showed that in one case there was progression of an arachnoiditis which had already been present during the first Amipaque study. In one other case there were minimal, unilateral nerve root changes caused by an intervening operation. Altogether 269 remyelographies without secondary late reactions are registered. Two cases of increased arachnoid changes from a previous myelography with another contrast medium hardly can be due to Amipaque.     

Aortocervical angiography with high and low osmolality ionic contrast media. A clinical investigation of metrizoate and ioxaglate

The influence of aortic arch injection of metrizoate 280 and 370 mg I/ml and ioxaglate 280 and 320 mg I/ml on EEG, heart rate, blood pressure, subjective responses, occurrence of involuntary movements and resulting image quality was investigated in 31 patients. Ioxaglate 320 produced less haemodynamic changes and subjective responses and as good image quality as the hyperosmolar contrast medium metrizoate 370 if subtraction procedure was used. Small and brief EEG changes were recorded in 9 of 14 patients. Only metrizoate 280 induced significant bradycardia. Involuntary movements on the film with the best demonstration of the vessels occurred with no difference between the contrast media. There was no correlation between involuntary movements and image quality. Our investigation indicates that an ionic contrast medium which is intended for aortocervical angiography should have a concentration of at least 320 mg I/ml, high viscosity, low osmolality and be no pure meglumine salt.     

Bolus geometry in various central and peripheral contrast medium applications: study with serial CT using non-ionic contrast media

Measurements of concentration in 27 patients with a calibrated Serio-CT yielded for the intravasal contrast medium bolus maximum a value of approx. 23 mg I/ml for the a. carotis with central injection and approx. 14 mg I/ml for the a. iliaca with peripheral injection. 7 invasive measurements were performed at the bifurcation of the aorta, yielding a value of 12.5 mg I/ml with peripheral injection. In all these cases, 40 ml nonionic contrast medium (Iohexol) with an iodine content of 350 mg I/ml were applied. The average bolus half-life was 9.5 sec. measured at the carotid artery, 11.5 sec. at the a. iliaca, and 7 sec. at the bifurcation of the aorta. Differences in bolus geometry were not seen on comparing arterial injection with cava superior injection; likewise, there were no differences between peripheral injections at various speeds. Animal experiments reported in literature show that these observations can be mainly ascribed to vascular dilatation in the minor circulation produced by the contrast medium.     

Iohexol and ioxithalamate for intravenous urography. A comparative parallel study

Omnipaque (iohexol) 350 mg I/ml has been compared with Telebrix (ioxithalamate) 380 mg I/ml in 48 patients undergoing intravenous urography. The contrast medium dose corresponded to 400 mg I/kg body weight. No cardiovascular reactions (BP and pulse rate) were observed. Subjective reactions occurred somewhat more frequently after Telebrix than after Omnipaque. Sensation of warmth was significantly less with Omnipaque (p less than or equal to 0.05). The overall radiological quality was equally good for the two contrast media.