Decreased Infarct Volume and Intracranial Hemorrhage Associated with Intra-Arterial Nonionic Iso-Osmolar Contrast Material in an MCA Occlusion/Reperfusion Model

Abstract

BACKGROUND AND PURPOSE:Infarct volume and intracranial hemorrhage after reperfusion with nonionic low-osmolar and isoosmolar iodinated IRCM has not been previously compared. We postulated that iso-osmolar and low-osmolar iodinated contrast media exert varied effects on cerebral infarct after intra-arterial injection. We compared infarct volume and hemorrhagic changes following intra-arterial infusion of iodixanol, iopamidol, or normal saline in a rat MCA occlusion/reperfusion model.

Effects of iodinated contrast on various magnetic resonance imaging sequences and field strength: Implications for characterization of hemorrhagic transformation in acute stroke therapy

“…SI was measured using similar sequences at both magnets, as follow: Spin-echo . The sequences were tailored to match a concomitant experiment of ICM infusion in a rat model of temporary ischemia performed on the same 3T magnet [8] . SI of each aliquot was measured and normalized to saline (SI contrast/SI saline).…”

“…Similarly, we did not compare side-by-side signal changes of blood and ICM (T1 and T2 relaxation times for blood are well known in the literature - Table 1). One potential limitation is that our T1-WI sequence was similar in both 1.5T and 3T magnets, with an optimized TR for high magnetic fields [8] . Even though this could lead to changes in SI not usually seen at 1.5T, we believe the characterization on T2-WI was significantly more conspicuous, particularly with iopamidol.…”

“…GRE: Gradient-echo; FLAIR: Fluid-attenuation-inversion-recovery. [8] . In conclusion, iopamidol and iodixanol are most conspicuous at high concentration on T2-WI, with limited conspicuity on GRE.…”

Outcome Differences between Intra-Arterial Iso- and Low-Osmolality Iodinated Radiographic Contrast Media in the Interventional Management of Stroke III Trial

“…2 It is reasonable to further hypothesize, then, that nonionic iso-osmolal IRCM may have a less harmful net effect in the setting of acute stroke than nonionic LOCM. No comparative data in IV or IA IRCM use in human stroke are available to refute that hypothesis.…”

“…1 Iso-osmolal iodixanol (290 mOsm/kg H 2 O) infusion led to smaller infarcts and less ICH compared with both low-osmolal iopamidol and saline in a similar model. 2 Dzialowski et al 3 reported reduced odds of favorable outcome in patients receiving intravenous IRCM for CT angiography before IV thrombolysis.…”