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2.
Semin Thromb Hemost ; 22 Suppl 1: 61-5, 1996.
Article in English | MEDLINE | ID: mdl-8807731

ABSTRACT

The prothrombotic effects of nonionic contrast media (NICM) have been evaluated in both biological and clinical studies. The question of whether there is a higher risk of thromboembolism during angiography with NICM than with ionic contrast media (ICM) has not yet been answered, nor has the precise role of the angiographic procedure per se in such complications been determined. The present study was performed to compare in vivo the potential prothrombotic effects during cardiac angiography of an NICM with those of an ICM, to estimate the effects of the procedure per se, and to assess how long these effects might be maintained. We measured blood levels of three markers of activation of blood coagulation: thrombin-antithrombin III (TAT) complexes, prothrombin fragment 1 + 2 (F1 + 2), and the split product of fibrin, D-dimer, before and after coronary angiography in three groups of patients. In group 1, 14 patients underwent coronary angiography with the NICM iopamidol 370. In group 2, 10 patients underwent coronary angiography with the ICM ioxaglate. In group 3, 10 patients were evaluated immediately after cardiac catheterization, before the injection of contrast material, as controls. No statistically significant differences between the three groups were found in TAT, F1 + 2, or D-dimer levels at different times before and after coronary angiography. There was a trend toward a transient increase in TAT levels after coronary angiography with iopamidol, which at first suggested a possible brief activation of hemostasis with this NICM, but a similar trend was also seen in the control group. We hypothesize that not only the type of contrast material, but also the angiographic procedure per se and patient-related factors all play roles in determining a prothrombotic state during coronary angiography.


Subject(s)
Antithrombin III/analysis , Cardiac Catheterization , Contrast Media/adverse effects , Coronary Angiography , Fibrin Fibrinogen Degradation Products/analysis , Peptide Fragments/analysis , Peptide Hydrolases/analysis , Prothrombin/analysis , Thromboembolism/blood , Aged , Biomarkers , Blood Coagulation , Female , Humans , Iopamidol/adverse effects , Ioxaglic Acid/adverse effects , Male , Middle Aged , Thromboembolism/etiology
5.
Radiol Med ; 76(3): 193-7, 1988 Sep.
Article in Italian | MEDLINE | ID: mdl-3262890

ABSTRACT

The authors report 13 cases of intestinal bleeding; while serials endoscopic and radiological examinations had been negative, arteriography allowed intestinal angiodysplasia to be diagnosed, and detected 18 lesions (12 of the right colon, 6 of the small bowel), confirming the fundamental role of arteriography in the diagnosis the localization and extension of these lesions. The importance of accuracy is emphasized both in the performance and in the evaluation of angiographic findings, in order to avoid missing multiple localizations (colon and small bowel). The authors illustrate and evaluate the different angiographic findings. Among these, the collection of contrast medium into parietal vascular lacunae and the early and dense opacification of the draining veins appear to be the most specific and frequent findings of angiodysplasia. In their series of patients the authors have also observed how the dilatation of the feeding artery, up to the antimesenteric side (a sign which is hardly ever reported in literature), was often present in the cecal localizations but could never be observed in the small bowel. Finally the surgical results and follow-up are considered.


Subject(s)
Angiography , Blood Vessels/abnormalities , Intestines/blood supply , Adolescent , Adult , Aged , Cecum/blood supply , Colon/blood supply , Female , Follow-Up Studies , Gastrointestinal Hemorrhage/etiology , Gastrointestinal Hemorrhage/surgery , Humans , Ileum/blood supply , Intestines/diagnostic imaging , Intestines/surgery , Jejunum/blood supply , Male , Middle Aged
8.
Minerva Med ; 78(9): 591-8, 1987 May 15.
Article in Italian | MEDLINE | ID: mdl-3495752

ABSTRACT

The cases are presented of 9 patients with intestinal angiodysplasia observed in 1979-85 in the surgery departments of San Carlo Borromeo Hospital, Milan. Diagnostic problems are discussed with particular reference to angiographic and endoscopic methods. Surgical treatment gave good results. Recurrent bleeding may depend on the inadequate assessment of the extension of the lesion or on the existence of other unrecognised intestinal sites.


Subject(s)
Gastrointestinal Hemorrhage/diagnosis , Intestines/blood supply , Adolescent , Adult , Aged , Blood Vessels/abnormalities , Female , Gastrointestinal Hemorrhage/diagnostic imaging , Humans , Male , Middle Aged , Radiography
10.
Nephron ; 46(2): 128-33, 1987.
Article in English | MEDLINE | ID: mdl-2885767

ABSTRACT

Nephrotoxicity of intravenous contrast media is more frequent and striking in patients with risk factors, the major one being preexisting chronic renal insufficiency. New nonionic low-osmolal contrast media allegedly have less nephrotoxicity than the traditional ionic high-osmolal ones. This was tested for two contrast media in a group of 18 patients with stable chronic renal insufficiency. The urinary excretion of two brush-border enzymes (alanine aminopeptidase, AAP, and gamma-glutamyl transpeptidase, gamma-GT) and of a lysosomal enzyme (N-acetyl-beta glucosaminidase, NAG), functional markers of tubular injury, were measured before and after intravenous urography with an ionic high-osmolal radiocontrast medium, meglumine sodium diatrizoate, or with a non ionic low-osmolal one, iopamidol. Urinary NAG excretion did not change significantly after administration of either contrast media. Urinary AAP and gamma-GT excretion increased significantly (p less than 0.01) after diatrizoate. After iopamidol, only gamma-GT excretion increased significantly (p less than 0.05). Our data suggest that the nonionic low-osmolal radiocontrast medium iopamidol is less toxic to tubules than the ionic high-osmolal medium diatrizoate and that the brush-border enzymes AAP and gamma-GT are sensitive markers for this toxicity.


Subject(s)
Contrast Media/adverse effects , Kidney Failure, Chronic/diagnostic imaging , Kidney Tubules/drug effects , Urography , Acetylglucosaminidase/urine , Adult , Aged , Aminopeptidases/urine , CD13 Antigens , Diatrizoate/adverse effects , Female , Humans , Iopamidol/adverse effects , Male , Middle Aged , Osmolar Concentration , gamma-Glutamyltransferase/urine
11.
Radiol Med ; 70(4): 176-9, 1984 Apr.
Article in Italian | MEDLINE | ID: mdl-6150520

ABSTRACT

An ionic (diatrizoate) and a non ionic (iopamidole) radiocontrast medium were compared as to their nephrotoxicity in a cohort of 21 patients with renal disease, 18 of which with normal renal function. The elevation of the urinary excretion of enzymes from renal tubular cells has been considered as a good index for renal tubular damage. We measured two lysosomal enzymes (NAG and beta glucuronidase) and a brush-border enzyme (gamma GT). In all patients we demonstrated an elevation of urinary excretion of the three enzymes already 12 hours after contrast medium administration. However, the elevation was statistically significant only after employment of the ionic contrast medium and concerned gamma GT and beta-glucuronidase; the urinary excretion of NAG did not vary significantly. Urinary enzymes levels returned to basal values 36 hours after intravenous pyelography. In conclusion, iopamidole showed a lower nephrotoxicity with respect to diatrizoate, as demonstrated by the lower levels of urinary enzymes excretion reached after its use.


Subject(s)
Contrast Media/toxicity , Kidney/enzymology , Acetylglucosaminidase/urine , Glucuronidase/urine , Humans , Kidney/drug effects , Urography , gamma-Glutamyltransferase/urine
13.
Arch Sci Med (Torino) ; 136(2): 331-6, 1979.
Article in Italian | MEDLINE | ID: mdl-518284

ABSTRACT

Radical operation of a right perirenal myxoid liposarcoma is reported. Retroperitoneal sarcomas, in fact, show little response to antiblastic and radiation management. It is pointed out that angiographic diagnosis is an essential prelmiminary to correct surgical indication, particularly since the clinical picture may well be indistinct and poorly specific.


Subject(s)
Liposarcoma/surgery , Retroperitoneal Neoplasms/surgery , Aged , Antineoplastic Agents/administration & dosage , Antineoplastic Agents/therapeutic use , Female , Humans , Liposarcoma/diagnosis , Liposarcoma/drug therapy , Prognosis , Retroperitoneal Neoplasms/diagnosis , Retroperitoneal Neoplasms/drug therapy
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