Contrast Iopromide Research Articles

Highly efficient CT contrast agent based on barium-doped mesoporous silica nanoparticles (SiO2-Ba NPs)

The synthesis of nanoparticles-based contrast agents (CA) has gained momentum in recent years due to their superior contrasting properties over conventional molecular counterparts. Herein, for the first time, we present the synthesis and contrasting properties evaluation of small (<50 nm) barium-doped mesoporous silica nanoparticles (SiO2-Ba NPs). We found that the X-ray attenuation efficiency of SiO2-Ba NPs was ∼4.5 times higher than that of a medically-employed Iopromide contrast agent under the same conditions. A leaching test revealed that the maximum level of Ba2+ ions escape was negligible indicating that the prepared SiO2-Ba NPs are structurally stable. Overall, the prepared SiO2-Ba NPs show great promise as effective CT contrast agents.

Safety asssessment of iopromide contrast media: a narrative review focusing on adverse events

Abstract Many clinical contexts require radiological exams based on contrast media administration. Iodinated contrast media (ICM) represents one of the most studied contrast agents often used in radiological examinations. ICM vary widely in their physicochemical properties, clinical uses, as well as in the incidence of adverse reactions (ARs). Therefore, a basic understanding of ARs occurrence, risk factors, clinical features, and management of ICM is increasingly important in clinical practice. Iopromide is a nonionic ICM widely used in clinical practice due to its favourable safety profile and numerous applications. This narrative review provides a comprehensive report of the available data concerning iopromide ARs. It also analyses iopromide ARs occurrence and frequency with diverse potential risk factors such as age, sex and pre-existing conditions.

Flow diagram of the differential diagnosis and clinical decision making in a rare case of contrast-induced encephalopathy following cardiac catheterization: a case report

BackgroundContrast-induced encephalopathy (CIE) is considered as an uncommon complication following cardiac catheterization. Due to the varied manifestations, CIE has no formal diagnostic criteria. In fact, the incidence of CIE may be greatly underestimated because of the difficulty in its differential diagnosis with other cerebrovascular complications. Thus, making a flow diagram according to patients’ clinical symptoms and examinations after cardiac catheterization to help clinicians diagnose CIE is important and needed.Case presentationIn this report, we describe a case of probable CIE in a 66-year-old Chinese man with hypertension who underwent cardiac catheterization with stents placement in the bifurcation lesion, during which 80 ml iopromide contrast was used. About 2 h following the procedure, the patient lost his consciousness suddenly and suffered from a status epilepticus. Malignant arrhythmias were not found through continuous electrocardiogram monitoring, but mild ST-segment elevation was displayed in leads I and aVL. The echocardiography, plasma glucose and electrolyte levels were normal. Emergency re-angiography with percutaneous transluminal coronary angioplasty was performed in the culprit lesion, which involved 60 ml iopromide contrast. However, the patient remained unconsciousness and epilepticus. Non-contrast computed tomography (CT) of the head showed cortical and subarachnoid enhancement as well as prolonged retention of contrast media in the middle cerebral artery. With supportive treatment of intravenous hydration, sedative and dehydrant, the patient recovered 3 h later and finally discharged without any neurological deficits.ConclusionsCIE is an acute reversible encephalopathy induced by contrast media. It is exceptionally challenging to make the diagnosis of CIE following cardiac catheterization since there is a lack of consensus on the definition of CIE. Via this case we reviewed the related literatures, through which a flow diagram of the differential diagnosis and clinical decision making was given, which could help to differentiate CIE from other neurological complications following cardiac catheterization.

Iopromide- and gadopentetic acid-derived preparates used in MR arthrography may be harmful to chondrocytes

BackgroundMagnetic resonance arthrography, a procedure through which contrast agents containing gadolinium and/or iopromide are administered intra-articularly, has become a useful tool in musculoskeletal diagnosis. Nevertheless, despite being considered safe for systemic use, certain tissue toxicities have been identified for both drugs. In this study, the effects of short-term exposure of human primary chondrocyte cell cultures to gadolinium and/or iopromide contrast agents were examined by assaying for stage-specific embryonic antigen-1 (SSEA-1) protein expression (a chondrogenic differentiation marker), cell viability, toxicity, and proliferation.MethodsHuman articular chondrocytes were grown in monolayer culture and were exposed to iopromide and/or gadolinium diethylenetriamine-pentaacetate (Gd-DPT) for 2 and 6 h. Cell cultures with no drug exposure were used as the control group. Cell differentiation status was assessed according to SSEA-1 protein expression. Contrast agent effects on cell viability and proliferation were analyzed using MTT analysis. Further, changes in cell morphology in relation to the control group were evaluated using inverted light microscopy, environmental scanning electron microscopy (ESEM), and 3-tesla magnetic resonance imaging. The obtained data were statistically compared.ResultsWhen compared with the control group, both SSEA-1 protein expression and cell proliferation were lowest in the Gd-DPT group (P = 0.000). There was a statistically significant correlation between SSEA-1 expression and MTT results (rho = 0.351; P = 0.003).ConclusionsNevertheless, the data obtained from in vitro experiments may not directly correspond to clinical applications. However, the mere fact that a drug used solely for diagnostic purposes may repress chondrocyte cell proliferation should be carefully considered by clinicians.

Safety Assessment of Iopromide Contrast Agent Utilization in a Computed Tomography Unit

Safety Assessment of Iopromide Contrast Agent Utilization in a Computed Tomography Unit

Contrast-induced acute kidney injury in patients with chronic kidney disease undergoing coronary catheterization: a comparative randomized study between iodixanol versus iopromide contrast media

Contrast-induced acute kidney injury in patients with chronic kidney disease undergoing coronary catheterization: a comparative randomized study between iodixanol versus iopromide contrast media

Contrast-induced neurotoxicity after coronary angiography

Contrast-induced neurotoxicity (CIN) is a very rare complication of coronary angiography. Clinical presentations include encephalopathy, seizures, cortical blindness, and focal neurological deficits. An inherent difficulty in understanding the natural history of the condition as well as its risk factors and prognosis is the rarity of its occurrence. To date, there are only case reports published on this complication. This was a retrospective analysis of 9 patients with CIN (8 men, 1 woman; mean age, 64.6 ± 7.8 years; range, 47-72 years) and coronary artery disease who were administered iopromide contrast agent. In the last 3 years, we diagnosed 9 patients with CIN. Of these, 8 patients (89 %) had hypertension. The clinical presentations of the patients were different on admission: 6 patients had acute coronary syndrome and 3 patients had stable angina pectoris. One patient had history of previous contrast agent exposure. All patients underwent coronary angiography with a low-osmolar nonionic monomer contrast agent (iopromide; Ultravist®-300, Bayer Healthcare). The mean volume of contrast injected was 177 ± 58 ml. The mean time between contrast agent administration and clinical symptoms was 100 ± 71 min (range, 30-240 min). While in 5 of the patients (56 %) the clinical sign of CIN was confusion, 2 had ophthalmoplegia, 1 had cerebellar dysfunction, and 1 had monoplegia. In 8 of 9 patients (89 %), neurological symptoms resolved after giving supportive medication and hydration. Only 1 female patient, who had bilateral ophthalmoplegia, did not recover. Neurological recovery occurred at a mean time of 14.2 ± 6.7 h (range, 8-30 h). CIN is a very rare condition. Advanced age, male gender, and hypertension are the greatest risk factors for CIN. Although the prognosis of CIN is benign, it can potentially cause permanent neurological deficits or death. We found that patients with ophthalmic involvement had a higher propensity for persistent deficit. On the basis of the current data, we propose 170 ml as the maximal recommended dose for coronary procedures.

Should monitoring of vancomycin be delayed? A case of likely nephrotoxicity occasioned by morbid obesity and minimal monitoring

Should monitoring of vancomycin be delayed? A case of likely nephrotoxicity occasioned by morbid obesity and minimal monitoring

Biodegradable X-ray markers of controlled radio-opacity

In order to analyze X-ray markers for potential use in biodegradable implants or radiostereogrammatic analysis (RSA), we combined iopromide contrast fluid with biodegradable calcium phosphate cement. The radio-opacity of 10×10 mm markers containing different iodine concentrations (0, 120, 240, 360 and 720 mg per gram cement) was compared to an aluminium wedge of increasing (1–10 mm) thickness. The addition of iopromide increased the radio-opacity in a dose-dependent manner, which was comparable to 9-mm aluminium at concentrations of 240–720 mg/g. Radiographs of markers placed in explanted rabbit and in human femora were made to investigate the clinical accuracy for position determination. Markers of 1×1 mm (120 mg/g) were clearly discernable in all femora, and could be used to adequately measure distances of 5–45 mm (accuracy 0.10–2.19 mm). These markers might be embedded in biodegradable implants or used as temporary markers in the bone to analyze postoperative position on radiographs.