Changes in endothelial, leucocyte and platelet markers following contrast medium injection during angiography in patients with peripheral artery disease

Peripheral artery angiography, a common diagnostic procedure, may cause ear ly and late adverse reactions, such as anaphylaxis, thrombosis and possible progression of the underlying arterial disease. To test the hypothesis tha t radiographic contrast medium may contribute to these events by adversely affecting the endothelium, leucocytes and/or platelets, 19 subjects undergo ing angiography for the investigation and/or treatment of lower limb athero sclerosis were recruited. Blood was obtained from the external iliac vein b efore, and at serial intervals after, the injection of radiographic contras t medium into the ipsilateral femoral artery for diagnostic use. Markers of endothelial cell injury (von Willebrand factor (vWf)), platelet activation (soluble P-selectin) and leucocyte activation (neutrophil elastase and sol uble L-selectin) were measured in citrated plasma. Soluble intercellular ad hesion molecule-1 (sICAM-1) and thromboxane BZ, which are non-specific mark ers of inflammation, were also measured. Compared with the sample prior to angiography, levels of soluble L-selectin and sICAM-1 were reduced (p <0.02 ) immediately after passage of the last bolus of contrast medium. 15 min la ter, levels returned to normal but the level of vWf had increased (p <0.02) . After 30 min, only levels of thromboxane Bz were increased (p <0.05). The following day both vWf (p <0.01) and soluble P-selectin (p <0.05) were inc reased. These data point to both early and late effects of contrast medium on markers of endothelial, platelet and leucocyte function.