Studies on the differences of major adverse cardio- And cerebrovascular events and the acute renal injury caused by contrast agents in Chinese patients of different ages receiving iodoxadol for PCI / 解放军医学杂志

Objective To explore the differences of the main adverse cardio- and cerebrovascular events (MACCE) and contrast-induced acute kidney injury (CIAKI) in Chinese patients of different ages who receiving percutaneous coronary intervention (PCI) therapy with iodoxanol. Methods A total of 3042 patients from 30 centers in China were enrolled in present IMPERIAL study (China clinical trial register: ChiCTR-ONC-13003733) from Oct. 30, 2013 to Oct. 7, 2015. Enrolled patients were observed for 3 days during hospitalization, and followed-up for one month after discharge. All the enrolled patients were divided into three groups according to their age: patients in group A aged less than 65 years (n=1748), in group B aged 65-75 years (n=828), and in group C were elder than 75 years (n=466). The primary end point was the incidence of MACCE (composite outcomes events of revascularization of target lesions, stroke, stent thrombosis, cardiac death and nonfatal myocardial infarction) and CIAKI in hospital 72 h after PCI. The secondary end point was the incidence of MACCE 72 h-30 d after PCI. Results Primary end point events among the three groups were shown as below: There was no statistical significance in revascularization of target lesions, stroke, stent thrombosis, cardiac death and nonfatal myocardial infarction (P>0.05). The incidence of CIAKI in group A, group B and group C [7.1% (121/1702), 7.8% (63/806), and 10.7%(49/458), respectively] showed statistical difference (P=0.016). And the incidence of cardiac death was 0% (0/1748) in group A, 0.12% (1/828) in group B, and 0.43% (2/466) in group C, showed significant difference (P=0.031). While the incidence showed no statistical significance (P>0.05) of revascularization of target lesions, stroke, stent thrombosis, and nonfatal myocardial infarction among the three groups. Conclusions Iodioxadol is safe and feasible for coronary intervention in Chinese patients of different ages, only CIAKI and the incidence of cardiogenic death after discharge increased with age.

Application of iodixanol in gemstone spectral imaging with low CT dosage / 中国基层医药

Objective To study the application value of iodixanol in gemstone spectral imaging with low CT dosage.Methods Forty hundred and twenty -six cancer patients with normal kidney function were selected .All of them underwent enhanced gemstone spectral CT scan with low dosage .They were individed into two groups with random number table,including observation group(n=213) and control group(n=213).The observation group was injected isotonic iodixanol ( 270 mgI/mL ) intravenously , while the control group was injected hypertronic iohexol (350mgI/mL) intravenously.With the same injection speed,the acute adverse reaction within 1h and delayed adverse reaction between 1h～7d were recorded.Meanwhile,the changes of Scr and Ccr ,the occurrence rate of contrast -induced nephropathy(CIN) and short -term prognosis were also recorded.Results Fifty-three patients occurred acute adverse reaction,among them 18 cases(8.45％) were in the observation group,35 cases(16.43％) were in the control group,there was statistically significant difference between the two groups (χ2 =10.791,P<0.05).Three patients(1.50％) of the control group occurred delayed adverse reaction ,no one was in the observation group .The adverse reaction disappeared after some time .Two kinds of contrast media caused slight increase of Scr and decrease of Ccr,but there were no statistically significant differences between them (all P>0.05).Conclusion The intrave-nous injection of iodixanol can reduce the occurrence of acute adverse reaction ,will not increase the incidence of CIN . It can be used safely .

Determination of Bacterial Endotoxin in Iodixanol by Kinetic Turbidimetric Method / 中国药师

Objective:To establish a method to determine the content of bacterial endotoxin in iodixanol. Methods:The standard curve of kinetic turbidimetric method was established and the dilution ratio was optimized by interference test. Bacterial endotoxin in the samples was determined. Results:The dilution ratio of 1 ∶12 did not interfere with the test. The recovery rate of bacterial endotox-in was 50%-200%. Conclusion:The kinetic turbidimetric method is suitable for the determination of bacterial endotoxin in iodixanol.

Safety and efficacy of domestic iodixanol injection in interventional neuroradiology:a multicenter clinical trial / 中国脑血管病杂志

Objective To investigate the safety and efficacy of domestic contrast iodixanol injection in the application of interventional neuroradiology. Methods A total of 442 patients from 11 research centers using iodixanol injection for whole brain DSA examination or interventional therapy were enrolled in a prospective,multicenter,and non-controlled clinical trial. The recording and evaluation indicators included the adverse reactions after drug treatment,changes of creatinine and urea nitrogen indicators before and after drug treatment,DSA types,DSA effects,the dosage of contrast agent,etc. The renal function damage, incidence of adverse drug reactions,and image quality were counted and analyzed. Results All the 442 patients were completed the examination or treatment. (1)All the results of intraoperative angiography achieved excellent,including 98. 2% (n = 434)were excellent and 1. 8% (n = 8)were good. There were significant differences in the comparison of angiographic results in the 4 different types of DSA (SIEMENS,PHILIPS,GE,and TOSHIBA)(χ2 = 31. 518,P 44. 2 μmol / L. There was no urea nitrogen abnormality of clinical signifi-cance. None of the patients had renal insufficiency. (3)Three patients had adverse drug reaction (0. 7%) during procedure,including 2 patients had dermal allergic reactions and 1 patient had transient blurred vision. Conclusion Domestic iodixanol injection is safe and effective and has less adverse reaction in the clinical application of interventional neuroradiology. The different types of DSA may impact on the contrast image quality.

Analysis of Contrast Media Iodixanol-induced Delayed Adverse Reaction With the Risk Factors in General Clinical Practice / 中国循环杂志

Objective: To investigate the incidence of coutrast media iodixanol-induced delayed adverse reaction with the risk factors in general clinical practice. Methods: A total of 20,185 patients with contrast iodixanol were recruited from 95 medical centers in China. The risk factors for adverse drug reaction as hypertension, asthma, previous contrast reaction were assessed;the administrative processes as route, injection manner, lfow rate of injection, prior heating of iodixanol were monitored and the demographic information was documented. The immediate adverse reaction within 1 hour of media administration and the delayed adverse reaction from 1 hour to 7 days after administration were recorded. The risk factors for iodixanol-induced delayed adverse reaction were studied by singlevariate and multivariate logistic regression analysis. Results: The overall iodixanol-induced adverse reaction rate was 1.52%, of which the immediate reaction was 0.58%and delayed reaction was 0.97%. The major delayed reaction was mild and it mostly happened in skin (0.68%) including rash, pruritus and urticaria. Multivariate logistic regression analysis revealed that male gender (OR=0.71, P=0.036), age (OR=0.82, P=0.001), route of administration (OR=0.21, P<0.001), prior heating of iodixanol (OR=1.44, P=0.036), lfow rate of injection (OR=1.28, P=0.001) and previous contrast reaction (OR=16.04, P<0.001) were the independent risk factors for delayed adverse reactions.

Subarachnoid Hemorrhage Mimicking Leakage of Contrast Media After Coronary Angiography

We report a patient who developed subarachnoid hemorrhage (SAH) just after coronary angiography (CAG) with non-ionic contrast media (CM) and minimal dose of heparin. The 55-year-old man had a history of acute ST elevation myocardial infarction that had been treated with primary percutaneous coronary intervention and was admitted for a follow-up CAG. The CAG was performed by the transradial approach, using 1000 U of unfractionated heparin for the luminal coating and 70 mL of iodixanol. At the end of CAG, he complained of nausea and rapidly became stuporous. Brain CT showed a diffusely increased Hounsfield unit (HU) in the cisternal space, similar to leakage of CM. The maximal HU was 65 in the cisternal space. No vascular malformations were detected on cerebral angiography. The patient partially recovered his mental status and motor weakness after 2 days. Two weeks later, subacute SAH was evident on magnetic resonance imaging. The patient was discharged after 28 days.

Iodixanol-Induced Fixed Drug Eruption Diagnosed by Systemic Provocation Test / 대한피부과학회지

Most cases of delayed skin reactions attributed to non-ionic iodinated contrast media, reported to date, have been maculopapular rash, which frequently occurs on the trunk and proximal region of the extremities. Only few cases of fixed drug eruption caused by non-ionic iodinated contrast media have been reported. A 48-year-old man developed multiple sharply marginated, hyperpigmented, oval patches on the trunk and extremities after receiving iodixanol (Visipaque(R), GE healthcare, USA). The patch test was carried out with a panel of the available iodinated non-ionic contrast media, but did not induce a positive reaction to any of the tested contrast media. The provocation test was carried out with iodixanol as 1/10 of the amount administered during the procedure that caused the reaction. On the following morning, the lesions increased in size and number. We report a case of iodixanol-induced fixed drug eruption, diagnosed by a systemic provocation test.

Late Adverse Reaction to Iodixanol (Visipaque(R)) / 대한내과학회지

Late adverse reactions to iodinated contrast medium are defined as reactions occurring 1 hour to 1 week after contrast medium injection. The majority of late adverse reactions are cutaneous reactions, and include itching, maculopapular rash, urticaria, erythematous patches, and angioedema. We report a patient with an iodixanol (Visipaque(R))-induced late adverse reaction. She was admitted for evaluation of nephrotic range proteinuria and edema. Abdomen and chest enhanced computed tomography was performed as a malignancy work-up. Sixteen hours after radiocontrast exposure, her entire body felt itchy. A maculopapular rash was first detected on her back and abdomen 24 hours after exposure, and spread over her entire body, including her face. Her skin lesions resolved completely in 5 days after administering steroid and antihistamine. We should consider late adverse reactions of iodinated contrast medium when we detect skin lesions late after radiocontrast use.

Late Adverse Reaction to Iodixanol (Visipaque(R)) / 대한내과학회지

Late adverse reactions to iodinated contrast medium are defined as reactions occurring 1 hour to 1 week after contrast medium injection. The majority of late adverse reactions are cutaneous reactions, and include itching, maculopapular rash, urticaria, erythematous patches, and angioedema. We report a patient with an iodixanol (Visipaque(R))-induced late adverse reaction. She was admitted for evaluation of nephrotic range proteinuria and edema. Abdomen and chest enhanced computed tomography was performed as a malignancy work-up. Sixteen hours after radiocontrast exposure, her entire body felt itchy. A maculopapular rash was first detected on her back and abdomen 24 hours after exposure, and spread over her entire body, including her face. Her skin lesions resolved completely in 5 days after administering steroid and antihistamine. We should consider late adverse reactions of iodinated contrast medium when we detect skin lesions late after radiocontrast use.

Use of iodixanol in coronary intervention for patients with diabetic renal insufficiency / 中华全科医师杂志

Objective To evaluate the safety of coronary intervention using iodixanol in patients with diabetic renal insufficiency.Methods Clinical data of 97 patients with diabetic renal insufficiency undergoing coronary intervention during June 2004 to June 2006 were retrospectively analyzed,50 of them with iodixanol,an iso-osmolar contrast medium (iodixanol group),and 47 with iopromide,a hypotanic contrast medium (iopromide group).Judkin's coronary angiography showed 167 diseased vessels in the patients,65 in anterior descending branches,44 in circumflex branches,and 58 in right coronary arteries. Levels of serum creatinine and blood urea nitrogen were determined before percutaneous coronary intervention (PCI),on the day of the procedure,the 3rd and 7th days after PCI,respectively,as well as radiocontrast media-induced nephropathy (CIN) was observed.Results Totally,192 drug-eluting stents were successfully implanted in 167 diseased vessels,and all patients' angina pectoris symptom disappeared soon after the procedure,with a full success.No acute or subacute stent thrombosis and major adverse cardiac events (MACE) occurred.Two patients (4%) in iodixanol group and 10 (21%) in iopromide group got CIN,with a statistical significance (P

A case of anaphylactoid reaction to nonionic contrast agent, Iodixanol (Visipaque(R)) during coronary angiography / 대한내과학회지

Radiocontrast agent infusion is the most common cause of non-IgE mediated anaphylactoid reaction in the modern medical procedures. The newer lower-osmolar nonionic contrast agents cause significantly lower adverse reactions than the high-osmolar ones. However, anaphylactoid reaction to nonionic contrast agent can cause life-threatening events and even death has been rarely reported. Iodixanol (Visipaque(R)) is a nonionic, dimeric contrast agent, which is currently used in cardiac catheterization. Here we report a case of anaphylactoid reaction to Iodixanol, a nonionic radiocontrast agent, during cardiac catheterization. A 45-year-old male patient underwent cardiac catheterization for evaluation of substernal pain during exercise. Five minutes after this contrast injection to the left coronary artery, he complained itching and dizziness. Subsequently, generalized urticaria, cyanosis and hypotension were developed. His coronary angiogram showed normal findings. He was treated with intravenous fluids, intravenous diphenhydramine, sucutaneous epinephrine and sympathomimetics and one hour later he recovered. This case suggests that anaphylactoid reaction to a radiocontrast media, iodixanol, should be considered in the list of differential diagnoses for cardiopulmonary arrest during cardiac catheterization.

Contrast Test of Injection Indisposition between Disome and Monomer Diagnostic Opaque in Femoral Arteriogram / 医疗卫生装备

Objective To compare the safety and efficiency of non -ionic monomer diagnostic opaque, iodixanol (Visipaque) and that of non -ionic disomer diagnostic opaque, iohexol (Omnipaque). Methods By comparing retrospectively the DSA opacification of 60 patients from 2006 to 2007, patients′ indispositions, adverse reactions and pictorial efficiency were recorded respectively. Results In the control group, iodixanol showed less indisposition caused by injection than iohexol and there′ s no obvious difference of indisposition. Both images met diagnostic requirements. Conclusion Both iodixanol and iohexol are safe, efficient and well -tolerant diagnostic opaque. Iodixanol is better than iohexol in indisposition caused by injection.

The Effect of the Isotonic Contrast Medium on the Renal Function of the High Risk Patients During Coronary Angiography / 实用放射学杂志

0.05).Conclusion The isotonic contrast medium has litter effect on the renal function of the patients with high risk factors.

Contrast-induced nephropathy in 532 patients undergoing coronary intervention / 中国介入心脏病学杂志

Objective To evaluate the incidence of contrast-induced nephropathy(CIN)in non-selected patients undergoing coronary angiography and intervention,and to investigate,the clinic risk factors of CIN as well as the renal safety of isosmolar iodixanol.Methods A total of 532 patients undergoing diagnostic coronary angiography or percutaneous coronary intervention were enrolled.Serum creatinine(SCr)was measured at any time within a week before the procedure and 2 days(48 hours)post procedure.The definition of CIN is the increase of serum creatinine of 44.2 ?mol/L(0.5 mg/dL)or 25% of the baseline at 48 hours after the use of contrast media.The effects of contrast media on renal function in patients undergoing coronary intervention were investigated and predictors of CIN were determined using logistic regression test.Results(1)Among the 532 patients,CIN occurred in 29 patients and the incidence of CIN in non-selected patients was 5.5%.(2)The incidence of CIN was significantly higher in patients with baseline eGFR