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The British Journal of Radiology May 2010Contrast media (CM) are reported to possess both prothrombotic and anticoagulant properties. The mechanisms are not clearly understood, and early reports are...
Contrast media (CM) are reported to possess both prothrombotic and anticoagulant properties. The mechanisms are not clearly understood, and early reports are contradictory. To study the effects of CM on haemostasis, we analysed the ex vivo effects of ioversol and iodixanol on platelet adhesion and P-selectin expression, and the in vitro effects of ioversol, iodixanol and ioxaglate on platelet adhesion, P-selectin expression and plasma coagulation. A novel enzymatic assay was used to measure platelet adhesion to protein surfaces, and an enzyme-linked immunosorbent assay was used to measure platelet P-selectin surface expression. Prothrombin time (PT) and activated partial thromboplastin time (APTT) were used to measure plasma coagulation. The ex vivo study consisted of blood from 27 outpatients administered ioversol and 9 patients administered iodixanol intravenously. Samples were collected before and 5 min after CM administration. Healthy donors were used for the in vitro studies on the effects of CM. The ex vivo study showed significantly (p<0.05) decreased platelet adhesion and P-selectin expression after administration of ioversol and iodixanol. Adhesion was more affected than P-selectin expression. The in vitro study showed that ioversol, iodixanol and ioxaglate significantly (p<0.05) and dose-dependently (beginning at 3 mg ml(-1)) decreased platelet adhesion and P-selectin expression. APTT and PT were significantly (p<0.01) prolonged at concentrations of 10 mg ml(-1) and 30 mg ml(-1), respectively. In conclusion, ioversol, iodixanol and ioxaglate inhibit platelet adhesion and P-selectin expression, as well as plasma coagulation. Platelets are more sensitive in relation to the inhibiting effect on plasma coagulation.
Topics: Adult; Aged; Aged, 80 and over; Blood Coagulation; Case-Control Studies; Contrast Media; Enzyme Assays; Enzyme-Linked Immunosorbent Assay; Female; Humans; In Vitro Techniques; Ioxaglic Acid; Male; Middle Aged; P-Selectin; Pilot Projects; Platelet Adhesiveness; Triiodobenzoic Acids
PubMed: 19546176
DOI: 10.1259/bjr/71758045 -
Acta Cirurgica Brasileira Jun 2018To compare the preventive effects of N-acetyl cysteine (NAC), ozone preconditioning and ozone treatment against contrast-induced nephropathy (CIN) in an experimental rat... (Comparative Study)
Comparative Study
PURPOSE
To compare the preventive effects of N-acetyl cysteine (NAC), ozone preconditioning and ozone treatment against contrast-induced nephropathy (CIN) in an experimental rat model.
METHODS
Thirty adult male Wistar rats were randomly distributed into five groups (n=6 for each group). Group I served as control and Group II had only contrast agent, while Group III received NAC and Group IV received intraperitoneal ozone 6 hours before and 6 hours after introduction of contrast agent. Ozone treatment was applied for 5 days after the contrast agent was introduced in Group V. After induction of CIN, groups were compared in terms of serum levels of urea, creatinine, neutrophil gelatinase associated lipocalin, protein carbonyl, total antioxidant capacity (TAC) as well as degree of renal injury at histopathologic level.
RESULTS
Groups II-V displayed more obvious histopathological alterations such as hemorrhage and renal tubular injury compared with Group I. TAC (p=0.043) and creatinine (p=0.046) levels increased significantly in Group II after the intervention. In Group III, protein carbonyl level diminished remarkably (p=0.046), while creatinine level was increased (p=0.046) following the intervention. TAC level was higher in Group IV (p=0.028) and Group V (p=0.026) following the procedure.
CONCLUSION
The N-acetyl cysteine and ozone treatment may alleviate the biochemical and histopathological deleterious effects of contrast-induced nephropathy via enhancement of total antioxidant capacity and decreasing oxidative stress.
Topics: Acetylcysteine; Animals; Antioxidants; Contrast Media; Creatinine; Ioxaglic Acid; Kidney; Kidney Diseases; Lipocalin-2; Male; Oxidative Stress; Ozone; Protein Carbonylation; Random Allocation; Rats, Wistar; Reference Values; Reproducibility of Results; Spectrophotometry; Treatment Outcome; Urea
PubMed: 30020312
DOI: 10.1590/s0102-865020180060000005 -
Osteoarthritis and Cartilage Mar 2013To compare delayed gadolinium-enhanced magnetic resonance imaging (MRI) of cartilage (dGEMRIC) and delayed quantitative computed tomography (CT) arthrography (dQCTA) to... (Comparative Study)
Comparative Study
OBJECTIVE
To compare delayed gadolinium-enhanced magnetic resonance imaging (MRI) of cartilage (dGEMRIC) and delayed quantitative computed tomography (CT) arthrography (dQCTA) to each other, and their association to arthroscopy. Additionally, the relationship between dGEMRIC with intravenous (dGEMRIC(IV)) and intra-articular contrast agent administration (dGEMRIC(IA)) was determined.
DESIGN
Eleven patients with knee pain were scanned at 3 T MRI and 64-slice CT before arthroscopy. dQCTA was performed at 5 and 45 min after intra-articular injection of ioxaglate. Both dGEMRIC(IV) and dGEMRIC(IA) were performed at 90 min after gadopentetate injection. dGEMRIC indices and change in relaxation rates (ΔR(1)) were separately calculated for dGEMRIC(IV) and dGEMRIC(IA). dGEMRIC and dQCTA parameters were calculated for predetermined sites at the knee joint that were International Cartilage Repair Society (ICRS) graded in arthroscopy.
RESULTS
dQCTA normalized with the contrast agent concentration in synovial fluid (SF) and dGEMRIC(IV) correlated significantly, whereas dGEMRIC(IA) correlated with the normalized dQCTA only when dGEMRIC(IA) was also normalized with the contrast agent concentration in SF. Correlation was strongest between normalized dQCTA at 45 min and ΔR(1,IV) (r(s) = 0.72 [95% CI 0.56-0.83], n = 49, P < 0.01) and ΔR(1,IA) normalized with ΔR(1) in SF (r(s) = 0.70 [0.53-0.82], n = 52, P < 0.01). Neither dGEMRIC nor dQCTA correlated with arthroscopic grading. dGEMRIC(IV) and non-normalized dGEMRIC(IA) were not related while ΔR(1,IV) correlated with normalized ΔR(1,IA) (r(s) = 0.52 [0.28-0.70], n = 50, P < 0.01).
CONCLUSIONS
This study suggests that dQCTA is in best agreement with dGEMRIC(IV) at 45 min after CT contrast agent injection. dQCTA and dGEMRIC were not related to arthroscopy, probably because the remaining cartilage is analysed in dGEMRIC and dQCTA, whereas in arthroscopy the absence of cartilage defines the grading. The findings indicate the importance to take into account the contrast agent concentration in SF in dQCTA and dGEMRIC(IA).
Topics: Adult; Aged; Arthrography; Arthroscopy; Cartilage, Articular; Contrast Media; Female; Gadolinium DTPA; Humans; Injections, Intra-Articular; Injections, Intravenous; Ioxaglic Acid; Knee Joint; Magnetic Resonance Imaging; Male; Middle Aged; Time Factors; Tomography, X-Ray Computed
PubMed: 23274105
DOI: 10.1016/j.joca.2012.12.009 -
ACS Nano Apr 2023Cartilage tissue exhibits early degenerative changes with onset of osteoarthritis (OA). Early diagnosis is critical as there is only a narrow time window during which...
Cartilage tissue exhibits early degenerative changes with onset of osteoarthritis (OA). Early diagnosis is critical as there is only a narrow time window during which therapeutic intervention can reverse disease progression. Computed tomography (CT) has been considered for cartilage imaging as a tool for early OA diagnosis by introducing radio-opaque contrast agents like ioxaglate (IOX) into the joint. IOX, however, is anionic and thus repelled by negatively charged cartilage glycosaminoglycans (GAGs) that hinders its intra-tissue penetration and partitioning, resulting in poor CT attenuation. This is further complicated by its short intra-tissue residence time owing to rapid clearance from joints, which necessitates high doses causing toxicity concerns. Here we engineer optimally charged cationic contrast agents based on cartilage negative fixed charge density by conjugating cartilage targeting a cationic peptide carrier (CPC) and multi-arm avidin nanoconstruct (mAv) to IOX, such that they can penetrate through the full thickness of cartilage within 6 h using electrostatic interactions and elicit similar CT signal with about 40× lower dose compared to anionic IOX. Their partitioning and distribution correlate strongly with spatial GAG distribution within healthy and early- to late-stage arthritic bovine cartilage tissues at 50-100× lower doses than other cationic contrast agents used in the current literature. The use of contrast agents at low concentrations also allowed for delineation of cartilage from subchondral bone as well as other soft tissues in rat tibial joints. These contrast agents are safe to use at current doses, making CT a viable imaging modality for early detection of OA and staging of its severity.
Topics: Rats; Animals; Cattle; Contrast Media; Cartilage, Articular; Tomography, X-Ray Computed; Ioxaglic Acid; Cations; Osteoarthritis; Early Diagnosis
PubMed: 36989423
DOI: 10.1021/acsnano.2c12376 -
Dento Maxillo Facial Radiology Jan 2017Non-tumour salivary diseases are common. Imaging studies are essential for their diagnosis and before undergoing an endoscopic or surgical treatment. In this study, we...
OBJECTIVES
Non-tumour salivary diseases are common. Imaging studies are essential for their diagnosis and before undergoing an endoscopic or surgical treatment. In this study, we aimed at presenting our procedure and results obtained with three-dimensional CBCT (3D-CBCT) sialography for non-tumour salivary gland diseases.
METHODS
Patients with parotid or submandibular salivary symptoms were examined by 3D-CBCT sialography. They received an intraductal injection of 0.5 mL of water-soluble contrast medium maintained in the gland, followed by examination in a NewTom wide-field CBCT device. Images were processed with multiplanar and 3D reconstructions.
RESULTS
A ductal exploration could be performed until the fourth divisions. The main lesions found were stones, stenosis, dilatations and "dead tree" appearance of the ductal system. No side effects of the catheterization or the iodine contrast were reported, nor tissue damages related to the contrast keeping technique.
CONCLUSIONS
3D-CBCT sialography seems to represent a reliable non-invasive diagnostic tool for ductal salivary diseases. More studies are needed to assess the value of 3D-CBCT sialography compared with conventional imaging.
Topics: Adult; Cone-Beam Computed Tomography; Contrast Media; Female; Humans; Imaging, Three-Dimensional; Ioxaglic Acid; Male; Salivary Gland Diseases
PubMed: 27588734
DOI: 10.1259/dmfr.20150431 -
Osteoarthritis and Cartilage Dec 2009Contrast agent enhanced computed tomography (CECT) may be used to detect depletion of superficial proteoglycans in articular cartilage. In principle, computed tomography...
OBJECTIVE
Contrast agent enhanced computed tomography (CECT) may be used to detect depletion of superficial proteoglycans in articular cartilage. In principle, computed tomography can also be used to diagnose the state of subchondral bone. Because osteoarthritis affects both cartilage and bone, we aimed to evaluate the feasibility of the CECT to simultaneously assess the state of these tissues. Further, we studied the spatial variation of contrast agent content in the CECT, properties of subchondral bone and the mechanical stiffness of articular cartilage across the bovine medial tibial plateau.
METHODS
Osteochondral samples (n=10) were prepared from fresh and visually intact bovine medial tibial plateaus. The dynamic mechanical modulus of the samples was measured using an arthroscopic indentation device. Subsequently, the samples were scanned with a peripheral quantitative computed tomography (pQCT) device prior to and after 35.5h of immersion in an anionic iodinated contrast agent, (ioxaglate) solution. The thickness of the cartilage was measured with ultrasound and pQCT.
RESULTS
In the medial tibial plateau, the site-dependent variation in the dynamic modulus, thickness of the cartilage, thickness of the subchondral plate and contrast agent content in the superficial cartilage was statistically significant (P<0.01). The linear correlation between the superficial contrast agent content and the dynamic modulus was rho=-0.80 (P<0.01).
DISCUSSION
The CECT enabled simultaneous analysis of the contrast agent penetration into cartilage, cartilage thickness and subchondral bone density and thickness. The contrast agent content in cartilage depends on the composition and structure of the tissue. Thereby the CECT also provided indirect information on the mechanical properties of the tissue, analogously to the dGEMRIC. Thus, the CECT may provide means to diagnose simultaneously the integrity of cartilage and subchondral bone in vivo.
Topics: Animals; Biomechanical Phenomena; Cartilage, Articular; Cattle; Contrast Media; Ioxaglic Acid; Proteoglycans; Stress, Mechanical; Tomography, X-Ray Computed
PubMed: 19615482
DOI: 10.1016/j.joca.2009.06.010 -
Journal of the American College of... Apr 1995The purpose of this study was to determine whether an adverse interaction exists between radiographic contrast agents and thrombolytic drugs.
OBJECTIVES
The purpose of this study was to determine whether an adverse interaction exists between radiographic contrast agents and thrombolytic drugs.
BACKGROUND
Coronary thrombosis may occur in the setting of unstable angina and after coronary angioplasty. However, the use of thrombolytic drugs in the setting of unstable angina has not been beneficial and, in one large trial of angioplasty in patients with unstable angina, was associated with an increased incidence of ischemic complications and abrupt closure. The reasons for these results are not clear. Coronary arteriography was performed in many of these trials, and it is known that fibrin structure and assembly are altered by radiographic contrast agents.
METHODS
Blood samples were obtained from patients before (n = 25) and after (n = 20) angiography using iohexol. Blood samples obtained before angiography were tested for response to streptokinase (10 and 100 IU/ml), urokinase (100, 200 and 500 IU/ml) and recombinant tissue-type plasminogen activator (rt-PA) (100 and 1,000 IU/ml) and the results measured. Iohexol, diatrizoate or ioxaglate (4% by volume) was added to separate aliquots of the baseline sample, and the test was repeated. Blood samples obtained after angiography were tested in a similar manner.
RESULTS
The onset of lysis at baseline by rt-PA at 1,000 IU/ml occurred at 72 +/- 8.2 s (mean +/- SD) and was markedly delayed in the presence of diatrizoate (527 +/- 181.7 s, p < 0.001) or iohexol (460 +/- 197.0 s, p < 0.001) but not ioxaglate. At 100 IU/ml, there was no lysis detected with rt-PA after the addition of any contrast agent. The addition of a contrast agent caused similar delays in the onset of lysis by urokinase and streptokinase; similar to rt-PA, the effect was smaller at higher concentrations of drug. In vivo blood samples obtained from the patient after angiography showed delays in the onset of lysis by rt-PA and urokinase but not streptokinase.
CONCLUSIONS
These data demonstrate that radiographic contrast agents impede fibrinolysis. This previously undescribed interaction was demonstrated using an in vitro test system, but these findings may have clinical relevance when thrombolytic drugs are used at the time of angiography.
Topics: Contrast Media; Coronary Angiography; Diatrizoate; Drug Interactions; Female; Fibrinolysis; Fibrinolytic Agents; Humans; In Vitro Techniques; Iohexol; Ioxaglic Acid; Male; Middle Aged; Streptokinase; Tissue Plasminogen Activator; Urokinase-Type Plasminogen Activator
PubMed: 7897118
DOI: 10.1016/0735-1097(94)00528-x -
Journal of the American College of... Nov 1992This study examined whether previous rejection episodes may have deleterious effects on coronary vascular reserve of heart transplant recipients months after... (Comparative Study)
Comparative Study
OBJECTIVES
This study examined whether previous rejection episodes may have deleterious effects on coronary vascular reserve of heart transplant recipients months after transplantation.
BACKGROUND
Coronary reserve has been demonstrated to be within the normal range in long-term transplant patients without previous episodes of rejection. Conversely, acute rejection is associated with a dramatic reduction of coronary reserve, which is rapidly restored after therapy.
METHODS
Coronary flow velocity was measured by intracoronary Doppler catheter before and after a maximally vasodilating dose of intracoronary papaverine in 16 control subjects and in 59 transplant patients classified into three groups with respect to time after transplantation: 1 to 6 months (group 1, n = 17), 7 to 18 months (group 2, n = 22) and > 18 months (group 3, n = 20). Coronary vascular reserve was evaluated through peak/rest coronary flow velocity ratio and minimal coronary vascular resistance index. All patients had normal findings on left ventricular angiography and coronary arteriography and a normal left ventricular mass.
RESULTS
Arterial pressure was normal in all groups. Heart rate in the three groups of transplant patients, mean aortic pressure in groups 1 and 2, left ventricular systolic pressure in group 2 and rate-pressure product in groups 1 and 2 were higher than in control subjects. Average number of rejection episodes per patient was similar in the three groups of patients (group 1, 2.4 +/- 1.4; group 2, 2.5 +/- 1.9, and group 3, 2.1 +/- 1.3). Results showed no difference between each group of transplant patients and control subjects for peak/rest coronary flow velocity ratio (control subjects, 5.2 +/- 0.8; group 1, 5.3 +/- 1.5; group 2, 4.9 +/- 1.2, and group 3, 4.4 +/- 1.6) and for minimal coronary vascular resistance index (control subjects, 0.18 +/- 0.03; group 1, 0.18 +/- 0.04; group 2, 0.20 +/- 0.06, group 3, 0.23 +/- 0.11). In addition, patients with zero or one rejection episode had similar values of peak/rest coronary flow velocity ratio and minimal coronary vascular resistance index (4.3 +/- 1.3 and 0.23 +/- 0.10, respectively, n = 22) as did those with one or two rejection episodes (5.1 +/- 1.5 and 0.19 +/- 0.07, respectively, n = 24), and those with four or more episodes (5.2 +/- 1.4 and 0.19 +/- 0.05, respectively, n = 13).
CONCLUSIONS
This study showed that coronary vascular reserve remains within normal range and is independent from the number of previous episodes of rejection until late after transplantation in human heart transplant patients with angiographically normal coronary arteries.
Topics: Analysis of Variance; Blood Flow Velocity; Cardiac Catheterization; Coronary Angiography; Coronary Vessels; Electrocardiography; Graft Rejection; Heart Transplantation; Heart Ventricles; Humans; Ioxaglic Acid; Isosorbide Dinitrate; Least-Squares Analysis; Papaverine; Recurrence; Subtraction Technique; Time Factors
PubMed: 1430683
DOI: 10.1016/0735-1097(92)90245-i -
Catheterization and Cardiovascular... Nov 2016To determine how two different types of iodinated contrast media (CM), low-osmolar ionic dimer ioxaglate (Hexabrix) and iso-osmolar non-ionic dimer iodixanol... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To determine how two different types of iodinated contrast media (CM), low-osmolar ionic dimer ioxaglate (Hexabrix) and iso-osmolar non-ionic dimer iodixanol (Visipaque), affect multiple indices of hemostasis.
BACKGROUND
In vitro models demonstrate differential effects of ionic and non-ionic CM on markers of hemostasis.
METHODS
This blinded endpoint trial randomized 100 patients to ioxaglate or iodixanol. The primary endpoint was change in endogenous thrombin potential (ETP) following diagnostic angiography. Secondary endpoints included change in markers of fibrinolysis [tissue plasminogen activator (tPA) and plasminogen activator inhibitor 1 (PAI-1)] and platelet aggregation following diagnostic angiography and percutaneous coronary intervention (PCI) with bivalirudin. Data are presented as median [interquartile range].
RESULTS
ETP significantly decreased after diagnostic angiography in both ioxaglate (baseline 1810 nM*minute [1540-2089] to post-angiography 649 nM*minute [314-1347], p < 0.001) and iodixanol groups (baseline 1682 nM*minute [1534-2147] to post-angiography 681 nM*minute [229-1237], p < 0.001), but the decrease was not different between CM (p = 0.70). There was a significant increase in ETP during PCI (n = 45), despite the use of bivalirudin, suggesting a prothrombotic effect of PCI (post-angiography 764 nM*minute [286-1283] to post-PCI 1081 nM*minute [668-1552], p = 0.02). There were no significant differential effects on tPA, PAI-1, and markers of platelet activity.
CONCLUSION
There were no significant differential effects between ioxaglate and iodixanol. Both CM led to significant reductions in thrombin generation and no significant effects on fibrinolytic activity or platelet activity, thereby contributing to a favorable antithrombotic milieu. © 2016 Wiley Periodicals, Inc.
Topics: Aged; Biomarkers; Contrast Media; Coronary Angiography; Coronary Artery Disease; Female; Fibrinolysis; Follow-Up Studies; Humans; Ioxaglic Acid; Male; Middle Aged; Percutaneous Coronary Intervention; Prospective Studies; Single-Blind Method; Thrombosis; Triiodobenzoic Acids
PubMed: 26773574
DOI: 10.1002/ccd.26353 -
Journal of the American College of... Oct 1998The aim of the present study was to evaluate the influence of radiographic contrast media (CM) on alteplase-induced coronary thrombolysis.
OBJECTIVES
The aim of the present study was to evaluate the influence of radiographic contrast media (CM) on alteplase-induced coronary thrombolysis.
BACKGROUND
Contrast media inhibit fibrinolysis in vitro and interact with endothelial cells, platelets and the coagulation system. The in vivo effects of CM on thrombolysis are not known.
METHODS
Occlusive coronary artery thrombosis was induced in 4 groups of 10 dogs by the copper coil technique. After 70 min of occlusion the dogs were randomized to intracoronary injection of 2 ml kg(-1) of either saline, a low-osmolar ionic CM (ioxaglate), a low-osmolar nonionic CM (iohexol) or a high-osmolar ionic CM (amidotrizoate). Thrombolysis with alteplase and co-therapy with aspirin and heparin was initiated after 90 min of occlusion. The coronary artery flow was monitored with an electromagnetic flowmeter throughout the experiment.
RESULTS
Iohexol and amidotrizoate, but not ioxaglate, were associated with longer reperfusion delays (time to optimal reperfusion: 67+/-48 min and 65+/-49 min, respectively, vs. 21+/-11 min after placebo; p < 0.05) and shorter periods of coronary perfusion (optimal perfusion time: 21+/-26 min and 21+/-28 min, respectively, vs. 58+/-40 min after placebo; p < 0.05). No significant differences were observed between groups with regard to activated partial thromboplastin times, circulating thrombin-antithrombin III complex concentrations and fibrinogen.
CONCLUSIONS
In this animal model administration of iohexol and amidotrizoate before thrombolysis significantly delayed reperfusion. This interaction should be considered in the design of clinical trials of thrombolytic therapy that evaluate coronary artery patency and in patients receiving local infusions of fibrinolytic agents.
Topics: Animals; Antithrombin III; Aspirin; Contrast Media; Coronary Thrombosis; Diatrizoate; Dogs; Drug Interactions; Fibrinogen; Hemostasis; Iohexol; Ioxaglic Acid; Myocardial Reperfusion; Partial Thromboplastin Time; Peptide Hydrolases; Thrombolytic Therapy; Tissue Plasminogen Activator; alpha-2-Antiplasmin
PubMed: 9768739
DOI: 10.1016/s0735-1097(98)00326-x