Document Detail

Variation in hemostatic parameters after intra-arterial and intravenous administration of iodinated contrast media.
MedLine Citation:
PMID:  1473919     Owner:  NLM     Status:  MEDLINE    
RATIONALE AND OBJECTIVES: A few case reports have suggested a possible thrombogenic effect of nonionic contrast media. In vitro investigations have lead to conflicting results. The authors performed three ex vivo studies to evaluate the influence of an ionic, ioxaglate, and a nonionic, iopamidol, low-osmolality contrast medium on a series of clotting and fibrinolytic parameters, after intravenous or intra-arterial administration, during routine diagnostic procedures. METHODS: In the first study, iopamidol was given to 20 consecutive patients through an arterial catheter for digital subtraction arteriography (DSA). In the second study, iopamidol was compared with ioxaglate. The media were randomly and blindly administered intravenously to 21 consecutive patients undergoing brain computed tomography (CT). Finally, ioxaglate was administered intra-arterially to 20 consecutive patients, in a situation comparable with that of the first study. RESULTS: In the first study, a weak anticoagulant effect and an activation of fibrinolysis were found, associated with indirect markers of thrombin generation, such as increased plasma levels of fibrinopeptide A (FpA) and thrombin-antithrombin III complexes (TAT). In the second study, no significant changes were seen with either contrast medium, for thrombin or fibrinolysis activation parameters. In the third study, the intra-arterially administered contrast medium elicited a marked increase of FpA and TAT, together with an anticoagulant effect. CONCLUSION: Both ionic and nonionic contrast media are able to interfere with the clotting/fibrinolytic system in the general circulation when they are administered to patients at the usual dosages. Ioxaglate shows more marked anticoagulant and thrombin-generating effects than iopamidol. The procedure (ie, arterial catheter versus intravenous infusion) seems to be more important than the category of contrast medium in conditioning the magnitude of these effects.
C Manotti; R Quintavalla; U Ugolotti; C Del Favero; A G Dettori
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Investigative radiology     Volume:  27     ISSN:  0020-9996     ISO Abbreviation:  Invest Radiol     Publication Date:  1992 Dec 
Date Detail:
Created Date:  1993-01-29     Completed Date:  1993-01-29     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  0045377     Medline TA:  Invest Radiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1025-30     Citation Subset:  IM    
Centro Malattie Emostatiche, Ospedale Regionale di Parma, Italy.
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MeSH Terms
Angiography, Digital Subtraction
Antithrombin III / analysis
Blood Coagulation Tests
Brain / radiography
Fibrinogen / analysis
Fibrinopeptide A / analysis
Hemostasis / drug effects*
Injections, Intra-Arterial
Injections, Intravenous
Iopamidol / administration & dosage*,  diagnostic use,  pharmacology
Ioxaglic Acid / administration & dosage*,  diagnostic use,  pharmacology
Leg / blood supply
Peptide Hydrolases / analysis
Plasminogen Activator Inhibitor 1 / blood
Tissue Plasminogen Activator / blood
Tomography, X-Ray Computed
Reg. No./Substance:
0/Plasminogen Activator Inhibitor 1; 0/antithrombin III-protease complex; 25422-31-5/Fibrinopeptide A; 59017-64-0/Ioxaglic Acid; 62883-00-5/Iopamidol; 9000-94-6/Antithrombin III; 9001-32-5/Fibrinogen; EC 3.4.-/Peptide Hydrolases; EC Plasminogen Activator

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