Comparative rheology of low‐ and iso‐osmolarity contrast agents at different temperatures

Abstract

Background: Several contrast media (CM) are used for diagnostic angiography and coronary percutaneous interventions. Catheter miniaturization allows performance of most diagnostic studies using 4-5 F catheters and interventions using 5-6 F catheters. As a result of catheter lumen downsizing and viscosity of CM, the operators are sometimes required to forcefully inject to produce adequate images. Methods and Results: The aim of the study is to perform a comparative rheology analysis between three different commonly used CM: iso-osmolar, nonionic iodixanol, Visipaque 1 , (GE Healthcare); low-osmolar, nonionic ioversol, Optiray 1 ; and low-osmolar, ionic ioxaglate, Hexabrix 1 , (Tyco Healthcare, US). The viscosity was experimentally assessed for temperature varying from 14 to 408C. To reproduce clinical use, an experimental set-up was used and the pressure developed to inject CM was evaluated at different temperatures and compared between the three CM. All three agents demonstrated a nonlinear inverse relationship between temperature and viscosity. At 148C iodixanol showed a twofold increase in viscosity compared with ioversol and ioxaglate. At 408C, the difference was reduced to 27%. At room temperature (208C), the difference in pressure needed to inject CM was 10% between iodixanol and ioxaglate and 6% between iodixanol and ioversol. As the temperatures increased, the differences in pressure became less important, becoming negligible (1%) at 378C. Conclusion: The viscosity of the iso-osmolar nonionic contrast agent iodixanol showed a stronger dependence on temperature compared with ioversol and ioxaglate. The impact of differences in viscosity and pressure to inject between CM were minimized at 378C. This emphasizes the importance of temperature control when using current lowosmolar CM and iso-osmolar CM with smaller sized catheters. '

Rate of Contrast Material Extravasations and Allergic-like Reactions: Effect of Extrinsic Warming of Low-Osmolality Iodinated CT Contrast Material to 37°C

“…Extrinsic warming of iodinated contrast material to 37°C reduces contrast material viscosity and has been advocated to decrease the frequency of adverse events related to intravenous administration (1)(2)(3)6,11,12 ) and to improve iodinated contrast material delivery ( 4,5 ). However, studies demonstrating effi cacy of a reduction in adverse risk from contrast material warming are scant, and the magnitude of demonstrable effect (when able to be shown at all [ 7 ]) has been small ( 6 ).…”

Impact of Contrast Agent Viscosity on Coronary Balloon Deflation Times: Bench Testing Results

“…An increasing proportion of procedures are being performed with 4 and 5 French diagnostic catheters, and radial percutaneous coronary interventions with guides as small as 4 French have been described . Brunette et al reported that significantly higher pressure was required for iodixanol to maintain similar catheter flow rates with ioxaglate at room temperature for adequate angiography. Coronary balloons are potentially more susceptible to the effects of high viscosity because of long catheter lengths and small lumen size.…”

Contrast induced acute kidney injury in interventional cardiology: an update and key guidance for clinicians

“…It is questionable whether the high viscosity should be considered to be a disadvantage when comparing the various ICM. Viscosity also depends on temperature: heating the ICM to bring the temperature close to that of the body considerably reduces viscosity (Brunette et al, 2008).…”