Contrast media for angiography: Physicochemical properties, pharmacokinetics and biocompatibility

Eloy, R.; Corot, Claire; Belleville, J

doi:10.1016/0267-6605(91)90045-h

Cited by 93 publications

(73 citation statements)

References 343 publications

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“…Contrast media used for the visualisation [1] of the vascular system (angiography) are neutral or ionic poly-iodo aromatic molecules ( Fig. 1) that are injected in large quantities in the blood vessels.…”

Section: Introductionmentioning

confidence: 99%

Angiography contrast agents interact with serine proteinases The molecular structure of the model system elastase/iohexol

Prangé

Gaudey²,

Ohanessian³

et al. 1995

FEBS Letters

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Pancreatic elastase was co-crystallised with iohexol, a tri-iodo benzenic contrast agent used in angiography analyses. The X-ray analysis of the complex reveals the presence of three molecules of iohexol associated with the proteinase with low occupancy factors. Two iohexol molecules are located in and near the active site of the enzyme and provide a model for explaining the inhibition of the hemostatic system, one of the major and inconvenient side effect associated with these chemicals.

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Section: Introductionmentioning

confidence: 99%

Angiography contrast agents interact with serine proteinases The molecular structure of the model system elastase/iohexol

Prangé

Gaudey²,

Ohanessian³

et al. 1995

FEBS Letters

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“…Iopamidol and iodixanol are non-ionic low osmolar contrast media and ioxaglate is an ionic low osmolar medium (Eloy et al, 1991). Experiments were performed using whole blood from healthy volunteers collected with hirudin and/or citrate as anticoagulant, in fresh non-anticoagulated blood and in hirudinized PRP.…”

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confidence: 99%

Differential effects of three radiographic contrast media on platelet aggregation and degranulation: implications for clinical practice?

et al. 1998

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Summary.We have determined the effects of three radiographic contrast media on platelet aggregation and degranulation in vitro. Aggregation was measured as loss of single platelets, and degranulation was measured as P-selectin expression using flow cytometry. Iopamidol added to hirudinized blood induced aggregation directly and also potentiated that induced by weak platelet agonists such as adenosine diphosphate (ADP). Iodixanol also potentiated platelet aggregation, but ioxaglate inhibited it. Iopamidol also caused marked platelet degranulation. The pro-aggregatory effect of iopamidol was evident in non-anticoagulated blood as well as in hirudinized blood, but not in citrated blood. In platelet-rich plasma (PRP) prepared from hirudinized blood neither iopamidol nor iodixanol directly induced platelet aggregation, but they rendered platelets hypersensitive to ADP. ADP antagonists inhibited the platelet aggregation and degranulation induced by iopamidol in whole blood, whereas aspirin, an inhibitor of thromborane A 2 synthesis, did not. These data are consistent with clinical reports of increased thromboembolic risk with non-ionic low-osmolar media, and raise concerns about the routine use of these contrast media during diagnostic and interventional arteriographic procedures. Routine use of citrate in previous experiments may have masked a pro-aggregatory effect of some contrast media.

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“…This could be interpreted as hemodilution, activity of adhesion molecules together with the WBCs, and consumption of platelets for clot or thrombus formation during procedures, 22 which support the findings of Belleville et al 20 Also, contrast material may modify CFI and/or its binding to the platelets, thereby changing platelet aggregation. 25,26 Platelet degranulation induced by nonionic contrast agents occurs despite the use of aspirin or heparin, and this degranulation augments the role of platelets in the activation of thrombin. Nonionic contrast material has been associated with decreased CFI concentration.…”

Section: Discussionmentioning

confidence: 99%

Effect of the radiographic contrast material iopamidol on hemostasis: an observational study in thirty cardiac patients

Kılınç¹,

Şaşmaz

Bozkurt

et al. 2003

Current Therapeutic Research

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Background: In vitro studies have shown that nonionic radiographic contrast material may induce the generation of thrombin in blood, whereas ionic contrast agents, such as iohexol, do not. However, knowledge of the effects of contrast material on coagulation and fibrinolytic systems in vivo is limited.Objective: This study was designed to assess the effects of the nonionic radiographic contrast material iopamidol on hemostasis in patients undergoing coronary angiography or cardiac catheterization.Methods: Patients aged Ն18 years with chest pain and/or dyspnea who underwent coronary angiography or cardiac catheterization with intra-arterial contrast material were assessed for hemostasis. Blood samples were drawn before and 3 minutes after injection of iopamidol. Complete blood count and coagulation profile (bleeding time, clotting time, clot retraction time, euglobulin lysis time [ELT], prothrombin and partial thromboplastin times, coagulation factor I [CFI] level, and platelet factor 3 [PF-3] availability) were assessed. The natural coagulation inhibitors protein C, protein S, and antithrombin III (AT-III) also were measured.Results: Thirty patients (7 males, 23 females; mean [SD] age, 51.3 [20.2] years; range, 17-79 years) were included in this single-center study. All hematologic variables (hemoglobin, white blood cell count, and platelet count) decreased significantly (P Ͻ 0.001, P Ͻ 0.001, and P Ͻ 0.05, respectively) after administration of iopamidol but remained within normal limits. Mean levels of protein C, protein S, and AT-III did not change significantly after administration of iopamidol. Bleeding time was not changed significantly, and PF-3 availability was prolonged in both groups, but the changes were not statistically significant. Conclusions:In this study population, although hemostasis remained grossly intact after injection of nonionic contrast material, the coagulation system may have been affected by the accelerated consumption of CFI and platelets. CURRENT THERAPEUTIC RESEARCHThe affected variables were platelets, clot retraction time, ELT, and natural coagulation inhibitors (protein C, protein S, and AT-III). Although the natural coagulation inhibitors remained within the normal range, the correlations were found significant. These changes in hemostasis affected the vascular phase. If the vascular compartment, especially the endothelium, remained intact, the infusion of nonionic agents in low concentrations might be safe for angiography and other procedures; however, more studies are needed. (Curr Ther Res Clin Exp. 2003;64:461-472)

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Contrast media for angiography: Physicochemical properties, pharmacokinetics and biocompatibility

Cited by 93 publications

References 343 publications

Angiography contrast agents interact with serine proteinases The molecular structure of the model system elastase/iohexol

Angiography contrast agents interact with serine proteinases The molecular structure of the model system elastase/iohexol

Differential effects of three radiographic contrast media on platelet aggregation and degranulation: implications for clinical practice?

Effect of the radiographic contrast material iopamidol on hemostasis: an observational study in thirty cardiac patients

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