M. Zwaan et al., Local effect of three nonionic contrast media on the arterial blood flow velocity during iliofemoral arteriography, INV RADIOL, 34(1), 1999, pp. 5-12
Citations number
31
Categorie Soggetti
Radiology ,Nuclear Medicine & Imaging","Medical Research Diagnosis & Treatment
RATIONALE AND OBJECTIVES. To investigate the influence of nonionic contrast
media on the arterial blood flow velocity (BFV) during iliofemoral arterio
graphy.
MATERIALS AND METHODS. ILofemoral arteriography with three contrast media-i
opromide, iopamidol, and iodixanol-was carried out in 55 patients in a pros
pective manner. Hemodynamic changes were investigated using the change in t
he maximal systolic BFV in the dorsal artery of the foot and were recorded
by simultaneous Doppler sonography.
RESULTS. Comparable reductions in BFV were demonstrated for iopromide and i
opamidol, but the iso-osmolar iodixanol produced no change in the maximal s
ystolic BFV, The reduction in BFV by iopromide and iopamidol is attributed
to a vasoconstrictive effect on the resistance vessels and is explained by
a direct depolarization of the vascular smooth muscles with predamaged endo
thelium; the effect lasts for less than 1 minute. The time from the greates
t change in BFV until the baseline value was achieved (recovery time) depen
ded on the degree of vascular damage present. This can be explained by the
inadequate compensation in circulatory regulation of patients with peripher
al arterial occlusive disease. Iodixanol's lack of influence on BFV may res
ult because its osmolality and chemotoxicity differ from those of iopromide
and iopamidol.
CONCLUSIONS. The peripheral hypoxemia observed in patients with arterioscle
rotic vascular changes can be expected to increase through the vasoconstric
tive effect of iopromide and iopamidol, whereas no such blood flow deficit
is to be expected with the use of iodixanol, Nevertheless, the reduction in
blood Bow is of short duration and thus will probably not contribute signi
ficantly to this hypoxemia.