ABSTRACT
Complex contact activation systems may have major involvement in side effects of i.v. contrast media. To investigate this, quantitative measurements of several factors (plasma prekallikrein, kallikrein inhibitory activity, haematocrit, alpha-2-macroglobulin, antithrombin III, alpha-1-antitrypsin and beta-thromboglobulin) were made before and after i.v. contrast phlebography in two groups of patients (each containing 21 patients) with no thrombosis, using a high- (meglumine iodamide) and a low-osmolality (ioxaglate) contrast medium. A statistically significant decrease in plasma prekallikrein was observed after the high-osmolality contrast medium, which is a sign of the activation of the kallikrein-kinin system and an indicator of the activation of the intrinsic coagulation. These events may play an important role in the adverse effects of contrast media.
Subject(s)
Contrast Media/toxicity , Iodamide/toxicity , Iodobenzoates/toxicity , Ioxaglic Acid/toxicity , Kallikreins/antagonists & inhibitors , Kallikreins/blood , Phlebography , Prekallikrein/blood , Antithrombin III/analysis , Hematocrit , Humans , Iodamide/analogs & derivatives , Iodipamide/analogs & derivatives , alpha 1-Antitrypsin/analysis , alpha-Macroglobulins/analysis , beta-Thromboglobulin/analysisABSTRACT
Comparisons of the non-ionic medium iohexol with the ionic media Na-Ca-Mg metrizoate and meglumine iodamide, were performed in two separate trials. The difference in diagnostic properties between the media was not significant. There was a significantly lower frequency of subjective sensations after iohexol than after metrizoate, whereas the difference between iohexol and iodamide in this respect was small. Regarding other adverse reactions there was a small advantage in favour of iohexol compared with metrizoate, whereas iohexol caused significantly less adverse reactions than iodamide.
