A Japanese phase III multicenter comparison of iotrolan 280 with iopamidol 300 in peripheral arteriography

Iotrolan 280 was compared with iopamidol 300 for safety and efficacy in peripheral arteriography in a randomized multicenter study of 148 patients. Both contrast agents provided good visualization with no statistical difference, between them. Pain and heat sensations following iotrolan were milder than after iopamidol. Adverse events occurred in three patients receiving iotrolan and four patients receiving iopamidol, with no statistical difference. The clinical value of iotrolan 280 was judged to be better than iopamidol 300 in peripheral arteriography on the basis of reduced pain and heat sensations.     

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.     

Ventricular fibrillation during right coronary arteriography with ioxaglate, iohexol and iopamidol in dogs

Radiograph contrast media (CM) are known to produce myocardial disturbances during cardiac angiography. The most severe electrical disturbance is ventricular fibrillation (VF). Previous studies using prolonged right coronary exposures have demonstrated a higher incidence of VF with dilute low sodium CM than with dilute CM containing more physiologic levels of sodium. In this study the incidence of VF was examined for more conventional concentrations of iopamidol, iohexol and ioxaglate and for sodium supplemented iohexol. The incidence of VF was determined during 25-second injections of contrast media into the canine right coronary artery at a rate of 0.4 mL/sec. Injections of iohexol and iopamidol at concentrations of 160, 240 and 320 mgI/mL produced significantly more VF (P less than .005, Fisher Exact Test) than meglumine/sodium ioxaglate or iohexol supplemented with 20 mM sodium chloride. The time required to produce a 50% incidence of VF with iohexol and iopamidol was significantly related to sodium concentration (r = .92, P less than .01).     

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.     

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.     

Iotrolan in urography: efficacy and tolerance in comparison with iohexol and iopamidol

Iotrolan was compared with iohexol and iopamidol for efficacy and general tolerance in excretory urography in three controlled, randomized, inte-individual, double-blind studies. Two hundred and eighty-four patients received fixed doses of 100 ml, 120 ml or 150 ml iotrolan 280 or iohexol 300/iopamidol 300 by rapid or bolus injection. Contrast quality in films taken 3–40 min after injection was rated by experienced radiologists both on an overall basis and with regard to distinct anatomical regions (parenchyma, pelvicalyceal system, ureter, bladder). In all studies, contrast quality was assessed as better in the iotrolan group. In two studies (dosages 100 and 120 ml), significant differences in contrast quality were found in lavour of iotrolan (P < 0.05), and in the third study (dosage 150 ml) there was a trend towards better contrast quality in the iotrolan group (P = 0.06). General tolerance of iotrolan was good with only minor side effects (iotrolan 6.3%, iohexol/iopamidol 9.9%), but the difference was not significant. No severe adverse reactions were observed with iotrolan. In comparison with non-ionic monomers, iotrolan shows very good efficacy and general tolerance for excretory urography.     

Iotrolan in urography: efficacy and tolerance in comparison with iohexol and iopamidol

Iotrolan was compared with iohexol and iopamidol for efficacy and general tolerance in excretory urography in three controlled, randomized, inte-individual, double-blind studies. Two hundred and eighty-four patients received fixed doses of 100 ml, 120 ml or 150 ml iotrolan 280 or iohexol 300/iopamidol 300 by rapid or bolus injection. Contrast quality in films taken 3–40 min after injection was rated by experienced radiologists both on an overall basis and with regard to distinct anatomical regions (parenchyma, pelvicalyceal system, ureter, bladder). In all studies, contrast quality was assessed as better in the iotrolan group. In two studies (dosages 100 and 120 ml), significant differences in contrast quality were found in lavour of iotrolan (P < 0.05), and in the third study (dosage 150 ml) there was a trend towards better contrast quality in the iotrolan group (P = 0.06). General tolerance of iotrolan was good with only minor side effects (iotrolan 6.3%, iohexol/iopamidol 9.9%), but the difference was not significant. No severe adverse reactions were observed with iotrolan. In comparison with non-ionic monomers, iotrolan shows very good efficacy and general tolerance for excretory urography.     

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.     

Outpatient arteriography: its safety and cost effectiveness

An 11-year experience with 2,029 outpatient arteriograms in a 500-bed community hospital with active vascular and cardiovascular services is reported. During this period 3,864 inpatient arteriograms were also obtained. The major complication rate has been lower for the outpatient procedures than for the inpatient procedures, and no malpractice claims have been made as a result of outpatient arteriography. There were considerable cost savings with the outpatient arteriography. Since conventional arteriography can be done safely and economically on an outpatient basis, and provides images of superior quality, it is considered highly competitive with digital subtraction angiography.