Discomfort assessment in peripheral angiography: Randomized clinical trial of Iodixanol 270 versus Ioversol 320 in diabetics with critical limb ischemia

Palena, Luis Mariano; Sacco, Zeno Dal; Brigato, Cesare; Sultato, Enrico; D, Barra; Candeo, Alessandro; Manzi, Marco

doi:10.1002/ccd.25412

Cited by 14 publications

(11 citation statements)

References 23 publications

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“…This suggests that treating physicians may preferentially administer IOCM to higher risk patients. Additionally, operators may select IOCM for perceived lower risks of major allergic complications or more tolerable symptoms during injection, particularly with peripheral procedures [31]. Despite their higher baseline risk, after adjusting for hospital fixed effects, patient demographics and comorbid conditions of the cohort, the use of IOCM was associated with fewer adverse events.…”

Section: Discussionmentioning

confidence: 99%

Iso-osmolar contrast media and adverse renal and cardiac events after percutaneous cardiovascular intervention

et al. 2018

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Aim: To assess the relationship between type of contrast media (CM), iso-osmolar contrast media (IOCM) or low-osmolar contrast media (LOCM), and major adverse renal and cardiovascular events (MARCE). Materials & methods: Coronary or peripheral angioplasty visits were stratified into CM cohorts: IOCM or LOCM. Multivariable regression analysis used hospital fixed effects to assess the relationship between MARCE events and type of CM. Results: Among 333,533 visits (357 hospitals), the incidence of MARCE was 7.41%. After controlling for observable and unobservable time invariant within-hospital characteristics, administration of IOCM versus LOCM was associated with a 0.69% absolute and 9.32% relative risk reduction in MARCE rate. Conclusion: Our study indicates that as compared with LOCM, IOCM may be associated with reduction of MARCE events in coronary or peripheral angioplasty patients. Arterial angiography and percutaneous intervention require administration of iodinated contrast media (CM) to render the blood vessels radiographically opaque. Contrast-induced acute kidney injury (CI-AKI) is one of the major adverse events associated with administration of iodinated CM [1,2]. The most common definition of CI-AKI is a rise in serum creatinine levels by ≥0.3 mg/dl within 48 h of contrast administration. CI-AKI has been associated with progression to advanced stages of chronic kidney disease (CKD) and with increased risk for major adverse cardiac events (MACE) [3,4].CI-AKI is the third most common cause of hospital-acquired renal failure and is associated with increased morbidity, prolonged hospitalization and higher rates of in-hospital and long-term mortality [5,6]. The incidence of CI-AKI varies from 2% in the general population to over 50% in high-risk groups [7]. In studies of the impact of the osmolality of iodinated CM, the use of low-osmolar contrast media (LOCM) has been shown to substantially reduce the risk of nephropathy when compared with high-osmolar CM [8][9][10][11].In several studies, iodixanol, iso-osmolar contrast media (IOCM) have been associated with lower risk for CI-AKI when compared with LOCM [12][13][14][15][16]. In a meta-analysis of 16 randomized controlled trials, McCullough et al. found that CI-AKI occurred less frequently for all patients in the iodixanol group when compared with the LOCM group [15]. Similar findings were reported for the subgroup of patients with CKD and for patients with CKD and diabetes mellitus. More recent meta-analysis concluded that iodixanol use was associated with less nephrotoxicity compared with LOCM and that use of iodixanol was associated with significantly fewer contrast-induced nephropathy events compared with LOCM [12]. Both meta-analyses concluded that intra-arterial

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Section: Discussionmentioning

confidence: 99%

Iso-osmolar contrast media and adverse renal and cardiac events after percutaneous cardiovascular intervention

et al. 2018

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“…Although, the type of contrast has varied in this context amongst studies, there has been a shift in many centers to use of non‐ionic low osmolar and particularly to iso‐osmolar agents in the setting of peripheral angiography . Reduction of patient pain and therefore unwanted patient motion during angiography has been the basis for the use of iso‐osmolar agents .…”

Section: Discussionmentioning

confidence: 99%

Acute kidney injury following peripheral angiography and endovascular therapy: A systematic review of the literature

Prasad

Ortiz-López

Khan

et al. 2016

Cathet Cardio Intervent

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“…For peripheral angiography, low osmolar agents were used more frequently in the survey. There is a small but growing body of literature which would support the use of iso‐osmolar contrast for peripheral imaging as there is less patient discomfort and motion artifact . Use of CO 2 for peripheral angiography was rarely used by the survey respondents.…”

Section: Discussionmentioning

confidence: 99%

Contemporary practice patterns related to the risk of acute kidney injury in the catheterization laboratory: Results from a survey of Society of Cardiovascular Angiography and Intervention (SCAI) cardiologists

Prasad

Sohn

Morales

et al. 2016

Cathet Cardio Intervent

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Discomfort assessment in peripheral angiography: Randomized clinical trial of Iodixanol 270 versus Ioversol 320 in diabetics with critical limb ischemia

Cited by 14 publications

References 23 publications

Iso-osmolar contrast media and adverse renal and cardiac events after percutaneous cardiovascular intervention

Iso-osmolar contrast media and adverse renal and cardiac events after percutaneous cardiovascular intervention

Acute kidney injury following peripheral angiography and endovascular therapy: A systematic review of the literature

Contemporary practice patterns related to the risk of acute kidney injury in the catheterization laboratory: Results from a survey of Society of Cardiovascular Angiography and Intervention (SCAI) cardiologists

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