Angiographic Contrast Media Research Articles

Effects of angiographic contrast media and hypertonic saline solutions on cerebral venous outflow in autoregulating brains.

Effects of angiographic contrast media and hypertonic saline solutions on cerebral venous outflow in autoregulating brains.

The physiologic response to superior mesenteric angiography.

Pressure in the carotid and femoral arteries and flow in the ascending aorta and superior mesenteric arteries were continuously monitored during selective injection of angiographic contrast medium into the superior mesenteric artery of anesthetized dogs. The response to injections of Hypaque 50%, Renografin–76%, and Conray–60% was an immediate increase in superior mesenteric artery flow. It peaked twenty to twenty-four seconds following injection, was 10 to 60% above base line after five minutes, and returned toward preinjection levels after fifteen minutes. The injections were also followed by a uniform rise in cardiac output and by a fall in diastolic blood pressure.

Mechanism of excretion of radioiodinated sodium iothalamate.

Sodium iothalamate (Conray), a triiodinated benzoic acid derivative, originally was prepared as a contrast medium for angiography and excretory urography (1). Recently Sigman et al. have shown that the simultaneous renal clearance of 131I sodium iothalamate and inulin in man were essentially the same (2, 3), and glomerular filtration rate (GFR) was determined rapidly and simply by counting plasma and urine radioactivity. It is likely that iothalamate is excreted primarily by glomerular filtration, although a fortuitous combination of filtration plus tubular secretion and reabsorption could explain these results. Because of the practical advantages in using radioiothalamate as an inulin substitute, additional studies of the mechanism of its excretion have been carried out with the aglomerular fish and the dog as experimental models. These results support the concept that iothalamate is excreted only by glomerular filtration. Materials and Methods Sodium iothalamate labeled with 131I or 125I was obtained fr...

Colonic injury resulting from angiographic contrast media

It appears that selective inferior mesenteric arteriography can be performed with relative safety using sodium iothalamate. Although a toxic effect was demonstrated in the present study, the minimal inherent toxicity of this angiographic contrast agent is such that mechanical trauma associated with performance of selective inferior mesenteric arteriography is the major determinant of the risk factor.

Experimental Evaluation of Concentrated Solutions of lothalamic Acid Derivatives as Angiographic Contrast Media

Experimental Evaluation of Concentrated Solutions of lothalamic Acid Derivatives as Angiographic Contrast Media

Effect of capillary pressure and plasma protein on development of pulmonary edema.

Effect of capillary pressure and plasma protein on development of pulmonary edema.

The Testing of the LD 50 for Angiographic Contrast Media in the Neonatal Rat

The Testing of the LD 50 for Angiographic Contrast Media in the Neonatal Rat

Effects of Angiocardiographic Injections on Blood Viscosity

THE RESULTS of a number of recent studies (1–5) indicate that modern angiographic contrast media may be employed with safety provided certain criteria of dosage and patient selection are observed. Their rapid and widespread clinical acceptance has fortified this opinion. It is not surprising, however, that serious complications continue to arise as a result of both the greater application of these agents in relatively poor-risk patients and the ever-present temptation to improve radiographic clarity by increasing the volume or rapidity of injection. While some of the reactions can be explained on the basis of sensitization, this mechanism does not appear to account for the majority of cardiovascular catastrophes which have occurred. Within the last few years emphasis has been focused on the marked hemodynamic effects which these severely hypertonic and viscid angiographic media produce, apparently a result of red cell crenation and agglutination (6–10). In a recent study involving the in vitro measurement...

Experimental evaluation of concentrated solutions of iothalamic acid derivatives as angiographic contrast media.

EXPERIMENTAL EVALUATION OF CONCENTRATED SOLUTIONS OF IOTHALAMIC ACID DERIVATIVES AS ANGIOGRAPHIC CONTRAST MEDIACAULEY W. HAYES, M.D., JOHN H. FOSTER, M.D., ROBERT SEWELL, B.S. and DUNCAN A. KILLEN, M.D.Audio Available | Share

Hemodynamic responses in the cerebral vessels to angiographic contrast media.

Hemodynamic responses in the cerebral vessels to angiographic contrast media.

An analysis of factors determining delivery rates of liquids through cardiac catheters.

To obtain optimal opacification of the cardiovascular system it is desirable to inject angiographic contrast medium at rapid and reproducible rates. All too often maximum diameter and minimum length of the catheter are determined by patient size. While this is a restriction, injection pressure, temperature, and the particular contrast agent are still available as variables. As opacification depends on the delivery rate of iodine rather than its volume, there are practical limitations to the benefits gained by increasing iodine content as opposed to losses incurred by-concomitant increases in viscosity. Previous attempts at analysis have relied on mathematical formulations for laminar and/or turbulent flow (1–4). As we shall see, since catheter flows encompass both ranges no one of these formulas is applicable for flows generated by pressure injectors. These flows are predictable by the standard engineering technic which plots friction factor and Reynolds number for tube flow. Material and Methods The cont...

Effects of angiocardiographic injections on blood viscosity.

THE RESULTS of a number of recent studies (1–5) indicate that modern angiographic contrast media may be employed with safety provided certain criteria of dosage and patient selection are observed. Their rapid and widespread clinical acceptance has fortified this opinion. It is not surprising, however, that serious complications continue to arise as a result of both the greater application of these agents in relatively poor-risk patients and the ever-present temptation to improve radiographic clarity by increasing the volume or rapidity of injection. While some of the reactions can be explained on the basis of sensitization, this mechanism does not appear to account for the majority of cardiovascular catastrophes which have occurred. Within the last few years emphasis has been focused on the marked hemodynamic effects which these severely hypertonic and viscid angiographic media produce, apparently a result of red cell crenation and agglutination (6–10). In a recent study involving the in vitro measurement...

Viscosity, solubility and toxicity in the choice of an angiographic contrast medium.

Viscosity, solubility and toxicity in the choice of an angiographic contrast medium.

THE EFFECT OF ANGIOCARDIOGRAPHIC CONTRAST MEDIUM ON CIRCULATORY DYNAMICS IN MAN. CARDIAC OUTPUT DURING ANGIOCARDIOGRAPHY.

The cardiovascular response to angiographic contrast medium was studied in 28 patients undergoing diagnostic angiocardiography under anesthesia. A transient phase of hypotension and tachycardia similar to that described by other authors was noted. Cardiac output was increased initially by 50 per cent and returned to the base line in 20 minutes. Peripheral blood flow increased by 100 per cent, apparently due to the direct effect of the hyperosmotic solution on the vascular smooth muscle. Hemodilution, maximal 2 to 4 minutes after injection of contrast medium, suggested a transient increase in circulating blood volume. Increased ventricular filling pressures, which were thought to be due to hypervolemia, were associated with increased left ventricular stroke work.

A SEVERE REACTION TO ANGIO-CONRAY.

Since January 1961, when the first report of the clinical use of Angio-Conray (sodium iothalamate 80 per cent) appeared, numerous articles have indicated this is the contrast medium of choice for aortography (1–6). Its physical and chemical properties have been described (1), and its low viscosity and relatively low toxicity represent a distinct advance in the field of radiographic contrast media. Complications were first recorded in 1961 by Dotter et al. (7) who encountered 2 in the course of 260 injections. Dotter's preliminary report suggested, however, that if further clinical experience confirmed initial impressions of relative safety and freedom from side-effects, Angio-Conray would warrant the term “drug of choice,” at least until a better preparation were found. Steinberg, who injected Angio-Conray intravenously in a series of over 400 patients, reported severe reactions in 6, all of whom recovered. The reactions were described as pallor, bradycardia, hypotension, apnea, and cardiac arrest. Bernstein et al. (8) performed clinical angiography in 44 patients; in 5 cardiac complications, including ventricular fibrillation, ensued. Several authors have found Angio-Conray the least toxic angiographic contrast medium yet tested, less toxic than any other available concentrated contrast medium, and therefore the agent of choice for intravascular injections (2). To the author's knowledge, there have been no reports of serious reactions during aortography, attributed to Angio-Conray. It is the purpose of this communication to emphasize that the search for an ideal compound, i.e., one entirely nontoxic that can be injected in smaller quantities than those now available, must continue as suggested by Steinberg. A case is presented in which immediate pharmacologic reaction occurred due to the injection of Angio-Conray, with deterioration directly following its administration, resulting in circulatory insufficiency unresponsive to treatment. This must be regarded as a complication of the injection, as recently suggested by Amundsen (9). Case Report A 58-year-old white male janitor was admitted to York Hospital for the first time on Jan. 1, 1963, with a chief complaint of shortness of breath of two years duration. During the two months prior to admission, the dyspnea increased markedly. The patient was unable to lie down and had a chronic nonproductive cough. A typical case of rheumatic fever at the age of sixteen with carditis and arthritis was reported, with a subsequent exacerbation at the age of twenty. Physical examination: Vital signs were normal. Minimal cyanosis of the nail beds and clubbing of the fingers were noted. Expansion of the thorax was limited and there was an increased thoracic diameter on the anteroposterior projection. The lungs were hyper-resonant, and the patient was unable to blow out a match four inches from his lips. Examination of the heart revealed generalized cardiomegaly.

A New Angiographic Contrast Medium, Sodium Iothalamate 80%

A new angiographic contrast medium, sodium iothalamate 80%, has been tested in experimental animals by standardized toxicity tests. The results were compared to results obtained with other currently employed concentrated media. Sodium iothalamate proved least toxic of any medium tested. This new medium has high radiodensity and low viscosity. In 248 clinical angiograms sodium iothalamate proved superior for all uses involving intravascular injection of concentrated contrast media.

Comparison of the cardiovascular effects of contrast media in cerebral angiography in man.

C EREBRAL angiographic contrast media recently have been compared on the basis of their cardiovascular effects after intracarotid injection in experimental animals. In the dog 1 and cat 4 abnormalities of cardiac rhythm and rate, arterial and venous blood pressure, and cardiac output were observed and related to the nature and the amount of the contrast material used. Three agents were tested in our laboratory. All three were triple-iodinated benzene-ring derivatives, varying in their side-chain structures. The Inethylglucamine salt of the diatrizoate compound (Cardiografin, Renografin) resulted in the fewest disturbances, the sodium salt of the diatrizoate compound (Hypaque) was intermediate in its effect and the acetrizoate compound ([~rokon) produced the most apparent disturbances. 1 Although the differences in the observed responses of the laboratory animals to these compounds were quite definite, it was felt desirable to compare the reactions to the same agents during human cerebral angiography. The doses injected in the dog (0.15 and 0.30 rnl./kg, of body weight) were higher than those used in a single injection in clinical angiography. A 7-ml. injection of contrast material in a 70-kg. patient represents 0.10 ml./kg. However, because of the differences in the relative calibers of the common, internal and external carotid arteries, the internal carotid ar tery of the dog received a smaller portion of the contrast media injected into

The organic iodide angiographic contrast media. Radiopacity and viscosity of the media as related to their potential for vascular opacification.

Vascular opacification by an organic iodide angiographic contrast medium is related to the ratio of agent to diluent (blood) at the instant of x-ray exposure. This implies a necessary conjunction of the properties of injectability and radiopacity of the contrast agent. The former is a function of viscosity, the latter of iodine content. Any attempt to increase iodine content of these contrast agents by augmenting concentration results in an elevation of viscosity. Therefore, the specific agent and the optimal concentration of the contrast solution desirable for maximum vascular opacification are not readily apparent. Method Viscosity was determined for Hypaque 90% (2:1 mixture of methylglucamine and sodium diatrizoate), Urokon 70% (sodium acetrizoate), Neo-iopax 75% (sodium iodomethamate), Diodrast 70% (Iododyracet) and Miokon 90% (2:1 mixture of methylglucamine and sodium diprotrizoate), and for serial dilutions to 50% concentration for each of these contrast agents by means of a simple gravity-flow viscometer under standard

Chapter IV: A rheological study of contrast media for angiography

Chapter IV: A rheological study of contrast media for angiography

A Rheological Study of Contrast Media for Angiography

A Rheological Study of Contrast Media for Angiography