| Systemic and regional haemodynamic effects of aortofemoral angiography. | |
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MedLine Citation:
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PMID: 10911780 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The aim was to investigate the regional and systemic haemodynamic consequences of bolus injection of fluids with different physical properties in the course of routine aortography. Iopamidol was compared with an equiosmolar solution of mannitol and with a 0.9 N saline solution. Continuous blood flow and Pulsatility Index (PI), as an index of regional vascular resistance, were measured by Doppler technique. Finger arterial pressure and heart rate were monitored at the time and for 3 min following each intraaortic bolus injections. The patients who underwent routine aortography were grouped according to the site of the flow measurements: common femoral artery, common carotid artery and brachial artery. Flow changes induced by the bolus infusion were evident for all the fluids but only at the femoral artery level. After an immediate (3 +/- 2 s) and brief (2 +/- 2 s) but marked reduction of flow and in-phase increase of PI following the bolus, further haemodynamic changes were observed only in the femoral artery, with a peak at 35 +/- 10 s and returning to baseline values after 70 +/- 15 s, in terms of both increased mean blood velocity and decreased PI. Saline and mannitol induced overall blood velocity alterations of 54% and 80%, respectively, and PI reductions of 44% and 57% compared with those induced by iopamidol. In the other vascular areas there was only a 17 +/- 2% increase of the physiological early diastolic backflow at the brachial artery level. Blood pressure decreased and heart rate increased in phase with the flow changes of the femoral artery. In conclusion: (1) a dramatic rheodynamic perturbation at the site of injection induces a vasodilating stimulus; (2) the haemodynamic response following injection results in marked vasodilation of only the tributary vascular bed; (3) flow steal may occur from other beds towards the lower limb vascular beds owing to vascular impedance imbalance; (4) a reduction of systemic arterial pressure is induced in phase with the regional vascular events and a reflex increase of the heart rate; and (5) the physical properties of the injected fluids influence the intensity of the perturbation, although the decisive triggering factor is the counterflowing bolus per se. |
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Authors:
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M Bardelli; M Fazio; F Cominotto; F Pozzi Mucelli; F Stacul; B Fabris; F Fischetti; C Ricci; R Carretta |
Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: The British journal of radiology Volume: 73 ISSN: 0007-1285 ISO Abbreviation: Br J Radiol Publication Date: 2000 Jun |
Date Detail:
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Created Date: 2000-08-02 Completed Date: 2000-08-02 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0373125 Medline TA: Br J Radiol Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 588-94 Citation Subset: AIM; IM |
Affiliation:
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Institute of Medicina Clinica, University of Trieste, Italy. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aortography Contrast Media / pharmacology* Diuretics, Osmotic / pharmacology* Female Hemodynamics / drug effects* Humans Injections, Intra-Arterial Iopamidol / pharmacology* Isotonic Solutions Male Mannitol / pharmacology* Middle Aged Sodium Chloride / pharmacology* Ultrasonography, Doppler |
| Chemical | |
Reg. No./Substance:
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0/Contrast Media; 0/Diuretics, Osmotic; 0/Isotonic Solutions; 62883-00-5/Iopamidol; 69-65-8/Mannitol; 7647-14-5/Sodium Chloride |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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