Pain in femoral arteriography. A double-blind, randomized, clinical study comparing safety and efficacy of the iso-osmolar iodixanol 270 mgI/ml and the low-osmolar iomeprol 300 mgI/ml in 9 European centers

PURPOSE: To compare the injection-associated pain and heat sensation after administration of the iso-osmolar contrast medium (IOCM) iodixanol (Visipaque trade mark 270 mg I/ml) and the low osmolar contrast medium (LOCM) iomeprol (Iomeron trade mark 300 mg I/ml) in femoral arteriography. MATERIAL AND METHODS: 352 patients received iodixanol or iomeprol in a prospective, double-blind, randomized, parallel-group clinical trial. The first injection during femoral arteriography (DSA with automated stepping) was standardized. Injection-associated pain and heat sensation, efficacy and safety up to 72 h were evaluated. RESULTS: The iodixanol group reported significant less injection-associated pain than the iomeprol group after the first injection (7.4% vs. 17.6%; p = 0.007), and after all injections (11% vs. 19.4%; p = 0.045). Iodixanol caused less heat sensation after the first injection (p = 0.007) and after all injections (p = 0.029). Heat sensations in the iodixanol group were less intense after all injections (p < 0.0001). No difference was found between the groups regarding the frequency of patients having adverse reactions (5.1% vs. 4%). CONCLUSION: The IOCM iodixanol caused significantly less frequent injection-associated pain and heat sensation than the LOCM iomeprol during femoral arteriography.     

Comparison of double-contrast CT arthrography image quality with nonionic contrast agents: isotonic dimeric iodixanol 270 mg I/mL and monomeric iohexol 300 mg I/mL

RATIONALE AND OBJECTIVES: The authors evaluated the image quality on delayed CT arthrography images with the use of the nonionic dimeric contrast agent, iodixanol 270 mg I/mL, compared with iohexol 300 mg I/mL. METHODS: A total of 132 patients with shoulder pain were included in a randomized, parallel, double-blind study. Sixty seven patients received iodixanol and 65 patients received iohexol. Patients underwent two CT-arthrography examinations: the first was performed 20 to 30 minutes after contrast injection and the second, 50 to 70 minutes after contrast injection. Data from 31 patients were excluded from the efficacy analysis. The overall quality of CT arthrography images was graded into four categories: excellent, good, moderate, and bad. RESULTS: The overall quality of delayed CT arthrography images was significantly better in the iodixanol group (P = 0.001, alpha = 0.05). On the first CT examination, image quality was good or excellent in 88% of the cases in the iodixanol group and in 96.1% in the iohexol group. The results on the delayed CT arthrography examination indicated that image quality was good or excellent in 88% of the cases when iodixanol was used and in 63.5% when iohexol was used. CONCLUSIONS: The overall quality of delayed images was significantly better with iodixanol than with iohexol.     

Iodixanol in cerebral computed tomography: a randomized, double-blind, phase-III, parallel study with iodixanol and iohexol

Iodixanol is a new nonionic dimer, isotonic with blood at all clinically relevant concentrations. Iodixanol (270 mg I/ml) was compared in a double-blind, randomized, parallel-group, phase-III study to the monomeric nonionic iohexol (300 mg I/ml) for evaluation of safety, tolerability and radiographic efficacy during cerebral CT. One hundred adult patients scheduled to undergo contrast-enhanced cerebral CT were randomly allocated to receive either iodixanol or iohexol. All completed the trial. Safety was evaluated by recording discomfort and other adverse events, tolerance by assessing intensity and incidence of discomfort. Radiographic efficacy was assessed from the diagnostic information and the radiographic density. No serious adverse events occurred. One patient (2 %) in the iodixanol group and one patient (2 %) in the iohexol group experienced a transient reddening at the neck and lower neck-line, respectively. Both contrast agents were well tolerated. One patient (2 %) in the iodixanol group and two patients (4 %) in the iohexol group experienced a sensation of warmth (discomfort) in connection with the injection. No difference between the two contrast media were noted radiographically. This comparison between iodixanol and iohexol showed both contrast media to be safe, well-tolerated and efficacious for use in cerebral CT. Received: 8 June 1998; Revision received: 26 August 1998; Accepted: 7 October 1998     

Myelography with a dimeric (iodixanol) and a monomeric (iohexol) contrast medium: a clinical multicentre comparative study

The purpose of this study was to evaluate and compare the radiographic efficacy and safety of iodixanol (Visipaque; 270 and 320 mg I/ml) and iohexol (Omnipaque; 300 mg I/ml) in myelography. The study was randomized, double-blind and comparative including 398 patients from five European university clinics. The radiographic visualisation was evaluated as poor, good or excellent. Adverse events were recorded by interviewing the patients after the myelography, and each patient was given a questionnaire to be returned after 1 week. In cervical myelography with cervical puncture more films with excellent quality was obtained after iodixanol 320 mgI/ml compared with iohexol 300 mgI/ml (p = 0.009). Also in lumbar myelography iodixanol 320 mgI/ml compared favourably with iohexol 300 mgI/ml (p = 0.006). The most frequent adverse event was headache, which occurred in 5–35 % of patients during the first 24 h and in 19–61 % within the first 7 days, depending on the centre. There was no difference in frequency and severity of the adverse effects between the contrast media. Received 13 March 1997; Revision received 29 December 1997; Accepted 5 January 1997     

Intra-arterial digital subtraction angiography with isotonic dimeric (iodixanol) and monomeric (iohexol) nonionic contrast media: radiographic,clinical and neurophysiological evaluation

Monomeric (iohexol 300 mg I/ml) and dimeric (iodixanol 270 mg I/ml) nonionic contrast media were compared in a double-blind, randomised, parallel group trial. Safety and efficacy of the media in intra-arterial cerebral digital subtraction angiography were evaluated by assessing adverse events, discomfort, EEG, heart rate and quality of radiodiagnostic information. Seventy-six patients underwent selective injection of the carotid and/or vertebral arteries. Both contrast media were well tolerated. No serious adverse events occurred. No effects on heart rate and EEG were evident. The arteriograms were of high quality and overall diagnostic information was optimal in 94% of the examinations. No clinically important differences between the two contrast media were found.     

Left ventricular systolic and diastolic function during coronary arteriography before and after acute left ventricular failure in dogs. A comparison between iodixanol, iohexol and ioxaglate

The hemodynamic side effects of intracoronary injection of low osmolality contrast media were studied in anesthetised dogs, both with and without left ventricular (LV) failure. LV failure was induced by microembolization of the area supplied by the left main coronary artery. LV pressure and volume, aortic pressure, and cardiac output were recorded. 6 ml iodixanol 320 mg I/ml containing 20 mmol Na+/l, a new non-ionic dimer, was compared to iohexol and ioxaglate. Iodixanol induced small systolic alterations both before and after LV failure. Iohexol increased LV inotropy while ioxaglate depressed myocardial function. Before failure iodixanol and ioxaglate impaired isovolumic relaxation, but early diastolic filling was not reduced. After failure the relaxation process was not affected, but ioxaglate reduced early diastolic filling. Ioxaglate also increased LV end-diastolic pressure and volume more than the non-ionic contrast media. In conclusion, iodixanol induced only small changes in systolic and diastolic function. Iodixanol should therefore be hemodynamically well tolerated during coronary arteriography, and also in acute ischemic heart failure.     

A comparison of blood-brain barrier disruption by intracarotid iohexol and iodixanol in the rabbit

A rabbit model was used to compare the effect on the blood-brain barrier of the intracarotid injection of two new contrast media: iohexol, a nonionic monomer, and iodixanol, a nonionic dimer. It was hypothesized that the low osmolality of iodixanol (272 mOsm/kg at 300 mgl/ml) would cause less disruption of the blood-brain barrier than the relatively higher osmolality of iohexol (690 mOsm/kg at 300 mgl/ml). The degree of blood-brain barrier disruption was assessed qualitatively, by observing the degree of cortical staining with Evans' Blue dye, and quantitatively, by calculating the difference in uptake of 99mTc-pertechnetate between injected and noninjected hemispheres. Statistical analysis of the results showed that both iodixanol and iohexol had a significantly greater effect on blood-brain barrier disruption than did isotonic saline (0.005 greater than p greater than .001), but that the effect of iodixanol was not significantly different from that of iohexol with respect to either Evans' Blue staining (p greater than .05) or pertechnetate uptake (.75 less than p less than .90). Thus, the low-osmolality iodixanol has no significant advantage over iohexol in terms of blood-brain barrier disruption after experimental carotid angiography.     

Injection-associated pain in femoral arteriography: A European multicenter study comparing safety, tolerability, and efficacy of iodixanol and iopromide

Purpose To evaluate injection-associated pain, safety, and efficacy with the isotonic contrast medium iodixanol (Visipaque 270 mg I/ml) compared with iopromide (Ultravist 300 mg I/ml) in femoral arteriography. Methods A multicenter, double-blind, randomized, parallel-group clinical investigation was carried out in 54 hospitals in Europe. Of the patients evaluated, 1225 received iodixanol and 1227 iopromide in conventional and/or digital subtraction angiography. Results The iodixanol group reported statistically significantly less injection-associated pain (0.9%) than the iopromide group (9.5%) (p<0.001). Further, 4.1% in the iodixanol group experienced pain and/or severe heat sensation vs 19.8% in the iopromide group (p<0.001). In the iodixanol group, 1.8% of the patients experienced contrast-related adverse events vs 2.4% in the iopromide group (p=NS). Overall diagnostic information was optimal for 94.1% in the iodixanol group and 95.3% in the iopromide group (p=NS). Conclusions Iodixanol 270 mg I/ml causes significantly less injection-associated pain during femoral arteriography and is as safe and efficatious as iopromide 300 mg I/ml.     

Dimeric versus monomeric nonionic contrast agents in visualization of coronary arteries

A cubital intravenous iodine contrast agent enhancement is used to visualize coronary arteries using EBT. The quality of the coronary artery visualization however is limited by the nearly simultaneous approximation of CT values in coronary arteries and myocardial tissue. The objective of the study was to evaluate if "under real clinical circumstances" the lower iodine concentration and the dimeric based characteristic of iodixanol may effect the kinetic of the applied contrast agent and the visualization of coronary arteries studied noninvasively by EBT. A double-blind, randomized, parallel study was performed in 111 cardiac patients, using iodixanol 270 mg I/ml or iohexol 300 mg I/ml. The kinetics of contrast enhancement was studied in the flow mode measuring following parameters: mean arrival time and mean time to reach peak CT values in the pulmonary trunk, transit time from the pulmonary trunk to the aorta as well as mean and maximum CT values in the left ventricular chamber and in the myocardium with respect to the body mass index. The mean difference of CT values in the left ventricular chamber and the myocardium was calculated. The length of the visualized coronary arteries was assessed and the diagnostic quality of coronary artery visualization scored on a visual analogue scale. Although iodixanol was used with a lower iodine concentration than iohexol there was no significant statistical difference between both groups with respect to the diagnostic visualization and length assessment of the coronary arteries as well as in the mean difference of CT values in the left ventricular chamber and the myocardium. This means that the advantageous dimeric characteristics of iodixanol may be used to reduce the amount of applicated iodine in contrast agents without loss of diagnostic image quality and information.     

120kVp条件下碘克沙醇(270mgI/mL)在冠状动脉CTA检查中的个性化应用研究

目的：研究120kVp条件下冠状动脉CTA（CCTA）检查中对比剂的个体化应用的效果。方法：回顾性搜集冠状动脉CTA检查中,个性化注射对比剂的连续患者的资料,共104例,与前期固定给药的连续患者资料进行比较。个性化给药组中,采用碘克沙醇（270mgI／mL）,剂量1mL／kg;注射流率根据患者体重设定：％54kg为4．0mL／s,55～64妇为4．5mL／s,65～74蚝为5．0mL／s,〉75kg为5．5mL／S。固定给药组中,采用碘帕醇（370mgI／mL）,总量为60mL,注射流率为4．5mL／s。两组病例的cT扫描方案相同。由有经验的影像医师对冠状动脉CTA图像进行主观评价,并对评价结果进行统计分析。测量两组患者右冠状动脉、左冠状动脉前降支、左冠状动脉回旋支近段、中段、远段的CT值,进行统计分析。结果：个性化给药组,平均体重为70．2妇,平均碘剂量为17．68gI／人;固定给药组,平均体重为67．6妇,平均碘剂量为22．2gI／人。两组病例,冠状动脉各节段图像质量均达到临床诊断要求。客观评估：两组病例,所有冠状动脉节段CT值均接近或〉300HU。结论：120kVp条件下,碘克沙醇（270mgI／mL）在CCTA检查中的个性化应用是可行的。此条件下,图像质量可达到临床诊断要求,同时降低对比剂用量,推荐用于肾功能损害高风险的人群。     

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.     

Comparison of vascular opacification after bolus injection of iodixanol-320 iohexol-350.

RATIONALE AND OBJECTIVES. The vascular opacification characteristics of a new nonionic, dimeric contrast agent, iodixanol, have been compared with a nonionic, monomeric agent, iohexol, using ultrafast computed tomography (UFCT). METHODS. In 10 experiments with mongrel dogs, the contrast agents were alternately injected into the animal's left atrium, and UFCT images were obtained at four cross-sectional levels through the carotid arteries. Time-density curves were then obtained for each carotid artery and each agent. The peak height and area under the curves were compared for each agent. RESULTS. Iohexol provided significantly (P < or = .05) greater opacification, determined by paired Student's t tests. CONCLUSION. This result was predicted from the greater iodine concentration of iohexol (350 mg/mL) compared with iodixanol (320 mg/mL); the difference was greater than expected based on iodine content alone.     

Iodixanol in paediatric gastrointestinal imaging: safety and efficacy comparison with iohexol

Iodixanol (Visipaque) is a dimeric, non-ionic iodinated contrast medium that is isotonic with blood at all clinically relevant concentrations. Iodixanol was compared in a randomized, double blind, parallel group, phase III multicentre trial with a monomeric, non-ionic contrast medium, iohexol (Omnipaque), at two concentrations assessing safety, tolerability and radiographic efficacy during contrast enhanced gastrointestinal radiography examinations of children. 154 children entered the trial; 152 formed the safety population and 147 the efficacy population. All examinations were performed following standard departmental practice. Children were assigned into either a high or low concentration group (iodixanol, 150 mgI ml(-1) and 320 mgI ml(-1) vs iohexol, 140 mgI ml(-1) and 300 mgI ml(-1)). The primary outcome measure for efficacy was the overall quality of visualization, which was assessed using a 100 mm visual analogue scale (VAS). The secondary efficacy variables assessed were quality of contrast opacification, mucosal coating and overall quality of diagnostic information. Safety evaluation involved patient follow-up for at least 48 h. Taste acceptance was also assessed. There was no statistically significant difference between the two contrast media with regard to the primary and secondary efficacy variables assessed, although higher ratings were observed for iodixanol. The 100 mm VAS score overall was 86 mm for iodixanol and 82 mm for iohexol (95% confidence interval -2.56, 10.42). The frequency of adverse events was lower for patients receiving iodixanol. Adverse events, mainly diarrhoea, occurred in 12 patients (16.2%) in the iodixanol group and 28 patients (35.9%) in the iohexol group. This reached statistical significance (p=0.006). Overall, iodixanol is well suited for examinations of the gastrointestinal tract, giving good efficacy results and fewer adverse events than iohexol.     

Gadolinium contrast media are more nephrotoxic than a low osmolar iodine medium employing doses with equal X-ray attenuation in renal arteriography: an experimental study in pigs

RATIONALE AND OBJECTIVES: To investigate in a unilaterally nephrectomized porcine model whether gadolinium contrast media (Gd-CM) are less nephrotoxic than iodine media (I-CM) in x-ray arteriography of a kidney made temporarily ischemic by arterial balloon occlusion. MATERIALS AND METHODS: In a noncrossover design, 3 mL of each test solution were injected in eight pigs (mean weight 19 kg) at a rate of 20 mL/min into the right renal artery at the start of a 10-minute period of ischemia. In group 1 (40 pigs) we injected 0.5 M gadopentetate, 0.5 M gadodiamide, 0.5 M iohexol (190 mg I/mL), 0.18 M iohexol (70 mg I/mL; with an x-ray attenuation equal to that of 0.5 M Gd-CM at 80 kV), and saline. In group 2 (24 pigs), we tested 0.18 M iohexol with ischemia and saline with and without ischemia. Gd- and iodine contrast media functioned as markers of glomerular filtration rate (GFR). When saline was tested, a low dose of iohexol (3 mL per pig; 300 mg I/mL) was injected as GFR marker intravenously in group 1 and into the renal artery in group 2. The plasma half-life elimination times of the CM 1-3 hours after injection were used to compare the effects of the different test solutions on GFR. Longer half-life means lower GFR. RESULTS: Group 1: median plasma half-life elimination time of the GFR marker was 3 340 minutes after injection of 0.5 M gadopentetate, 256 after 0.5 M gadodiamide, 179 after 0.5 M iohexol, 143 after 0.18 M iohexol, and 133 minutes after saline. All differences except that between 0.18 M iohexol and saline were statistically significant (P < .01). Group 2: median plasma half-life was 174 minutes after 0.18 M iohexol with ischemia, 196 minutes after saline with ischemia, and 195 minutes after saline without ischemia. There were no significant differences between the test solutions in group 2 (P > .05). CONCLUSION: In pigs, 0.5 M Gd-CM were more nephrotoxic than both equal-attenuating (70 mg I/mL) and equimolar (190 mg I/mL) concentrations of the I-CM iohexol. These results do not support the "off-label" use of Gd-CM for renal x-ray arteriography in man instead of commercially available concentrations of iodine contrast media at 140, 150 and 180 mg I/mL or diluted to 70 mg I/mL.     

Effect of an iso-osmolar contrast medium on pulmonary arterial pressure at pulmonary angiography

A clinical comparison of the effects on pulmonary arterial pressure induced by contrast media with various osmolalities, iohexol 140 mg I/ml (300 mosm/kg H2O), iohexol 300 mg I/ml (690 mosm/kg H2O), and diatrizoate 292 mg I/ml (1480 mosm/kg H2O) following selective pulmonary angiography was made in 12 patients with normal pulmonary arterial pressure. A double-blind crossover study was performed and the contrast media were administered in random order. The pulmonary arterial pressure was recorded continuously before, during, and for 3 min after the injection. The effect of iohexol 140 on the pulmonary arterial pressure was significantly less marked than that of diatrizoate 292, whereas no statistical significance was shown between iohexol 140 and iohexol 300. These results indicate that iso-osmolar contrast medium (iohexol 140), as well as iohexol 300, would be better tolerated than diatrizoate 292, and is therefore a safer contrast medium for selective pulmonary angiography.     

Iodixanol and iohexol in cardioangiography. A comparative vectorcardiographic study

Purpose: The non-ionic dimeric contrast medium (CM) iodixanol is isotonic with blood through the addition of electrolytes. In this study, we evaluated computerised dynamic vectorcardiography (VCG) as a tool in CM research by comparing the electrophysiological effects of iodixanol with those of the low-osmolar CM iohexol.Material and Methods: A total of 119 patients referred for cardioangiography were included in this double-blind, randomised, parallel comparison of iodixanol (320 mg I/ml) and iohexol (350 mg I/ml). VCG was recorded and different VCG parameters were analysed. General tolerability, safety and radiographic efficacy were also assessed.Results: Iodixanol induced less changes than iohexol in all VCG parameters and the sensation of warmth was significantly milder after iodixanol, but both CM were well tolerated. VCG might be useful in future studies to analyse electrophysiological effects caused by CM.     

Intravenous urography with a new non-ionic contrast media in a clinical phase III study: iopentol vs iohexol

The safety and diagnostic efficacy of iopentol 300 mg I/ml were compared with iohexol 300 mg I/ml in 300 patients submitted for urography. The study was carried out as a double-blind, randomised parallel study where 149 patients received iopentol and 150 patients iohexol. There were no significant differences between the patients receiving the two contrast media with regard to demographic parameters, rate of injection or total dose of injected contrast media. No changes in blood pressure and no clinically important changes in heart rate were detected in the two groups. No serious adverse effects occurred. Seven patients (5%) in the iohexol and 12 patients (8%) in the iopentol group experienced adverse effects other than a sensation of warmth. Fourteen iohexol patients (9%) and 18 iopentol patients (12%) experienced warmth related to the contrast injection. Excellent films were obtained in most patients and no difference in diagnostic quality between iopentol and iohexol was observed.     

Blood pool and liver enhancement in CT with liposomal lodixanol: comparison with lohexol

RATIONALE AND OBJECTIVES: The authors compared the time course and blood pool and hepatic enhancement of three different doses of liposomal iodixanol with those of iohexol. MATERIALS AND METHODS: A liposomal iodixanol formulation was prepared with 200 mg of iodine per milliliter total and 80 mg of iodine per milliliter encapsulated. Twelve normal New Zealand white rabbits divided into four groups received 75-, 100-, or 150-mg encapsulated iodine per kilogram doses of liposomal iodixanol or 2 mL/kg iohexol with 300 mg of iodine per milliliter. A liver section was scanned with serial computed tomography (CT) before the injection, immediately afterward, and at 1-minute intervals for 10 minutes. Region-of-interest measurements of the aorta and liver were plotted at each time point, and contrast enhancement was plotted as a function of time and iodine dose. RESULTS: All liposomal iodixanol doses produced greater liver enhancement than iohexol. Results were significant (P < .05) for 100 mg and 150 mg iodine per kilogram dose groups at time points beyond 2 minutes. Peak hepatic enhancement (change in attenuation) was 54.9 HU +/- 7.6 with iohexol, compared with 59.6 HU +/- 6.1, 73.3 HU +/- 3.6, and 104.1 HU +/- 8.8 for 75, 100, and 150 mg encapsulated iodine per kilogram doses, respectively. Hepatic enhancement increased rapidly after injection of liposomal iodixanol, plateauing 2-3 minutes later. Blood pool enhancement decreased rapidly. Steady-state liver enhancement with liposomal iodixanol increased linearly with dose. Aortic enhancement was greater with iohexol. CONCLUSION: Liposomal iodixanol yielded greater hepatic enhancement at lower total iodine doses than iohexol. Although liver enhancement occurred rapidly after injection, blood pool enhancement was brief.     

Comparison of iodixanol with iohexol for delayed pelvic venous opacification: a preliminary study of potential use for CT venography

OBJECTIVE: The goal of this prospective randomized study was to determine whether isosmolar contrast material offers an advantage over low-osmolar contrast material for delayed venous opacification in CT venography. SUBJECTS AND METHODS. We prospectively enrolled 200 adult outpatients. Patients were randomized to receive either the low-osmolar (hyperosmolar to blood) nonionic contrast medium, iohexol, or the nonionic isosmolar contrast medium, iodixanol. Images were obtained before contrast administration and 180 sec after contrast administration through the pelvis at the level of the external iliac vessels. Opacification of the external iliac vessels was assessed both objectively and subjectively. RESULTS: The arterial and venous densities before contrast administration were approximately 45 H for both groups. On delayed images obtained after contrast administration, the mean venous density was 95.2 H for iohexol and 101.4 H for iodixanol. Changes in venous density due to administration of iohexol and iodixanol were 49.8 and 56.1 H, respectively. This 12.5% difference was highly significant (p = 0.002). Sixty-six percent of the images in the iodixanol group were rated either 4 (good) or 5 (excellent), whereas only 36% of the iohexol group achieved a similar rating on our subjective rating scale. This difference was statistically significant (chi(2) = 16.4, p < 0.001, df = 1). CONCLUSION: Our study shows that isosmolar contrast material provides significant improvement in delayed opacification of the external iliac vessels in comparison with conventional low-osmolar contrast medium (hyperosmolar to blood).     

Iodixanol,a new non-ionic,dimeric contrast medium in cardioangiography: a double-masked,parallel comparison with iopromide

Iodixanol (320 mg I/ml) was compared with iopromide (370 mg I/ml) in a double-masked, parallel group, randomised trial of 120 patients undergoing cardioangiography in order to evaluate and compare safety, tolerability and radiographic efficacy. The overall diagnostic information and radiographic density were mainly optimal and no differences between the contrast media were detected. No serious adverse events were reported in either group, and there were no clinically relevant changes in blood chemistry. A statistically significant difference was found between the groups regarding discomfort during injection of contrast medium, the intensity of warmth being less for iodixanol (P = 0.003). Blood pressures and heart rate remained practically unchaged during coronary arteriography in both groups. During left ventriculography, the peak systolic pressure decreased after injection of iopromide (mean change ±SD: – 7.9 ± 11.1 mm Hg, P < 0.001), while there was no significant change after injection of iodixanol (mean change± SD: 0.9 ± 8.3 mm Hg). The results indicate that both contrast agents are effective, safe and well tolerated in cardioangiography, but administration of iodixanol results in a less intense sensation of warmth and a slightly better haemodynamic profile than does administration of iopromide. Correspondence to: H. Manninen