Angiographic guidewire with measuring markers: design and clinical experience.

PURPOSE: We have developed an angiographic guidewire with measuring markers to determine accurately how far a guidewire is inserted within a catheter. We investigated whether use of this guidewire reduces the risk of vascular injury and the fluoroscopic time during guidewire manipulations. METHODS: Four markers were put on the surface of the guidewire at 80, 100, 110, and 120 cm from the tip. The actual lengths of 54 catheters from seven manufacturers were measured and compared with the nominal lengths. Sixty consecutive patients who underwent angiography were randomized into two groups: in one group guidewires with surface markers were used (marker group) and in the other group, conventional guidewires (control group). For each guidewire insertion, the fluoroscopic time before the guidewire was pushed forward into the vessel lumen was recorded. The number of occasions on which unintentionally the guidewire had already been pushed out of the catheter at the start of fluoroscopy was also evaluated. RESULTS: The actual lengths of all catheters were greater than the nominal lengths by 1.0-11.0 cm. Mean fluoroscopic time for each guidewire insertion was 3.3 sec in the marker group and 5.7 sec in the control group (p < 0.05). Guidewires were unintentionally pushed out of the catheters without fluoroscopy three times (3.6%), in each case in the control group. CONCLUSION: The guidewire with measuring markers is effective for enhancing safety and in reducing fluoroscopic radiation during angiographic procedures. It is recommended that operators be aware that actual lengths of catheters may vary significantly from the nominal lengths listed; they should be aware of this with any guidewire, but particularly with the angiographic measuring guidewire.

Human comparative study of zinc and copper excretion via urine after administration of magnetic resonance imaging contrast agents.

PURPOSE: To evaluate the in-vivo pharmacokinetics of magnetic resonance imaging (MRI) contrast agents, the excretion of zinc and copper via urine was studied for three gadolinium (Gd) chelate complexes. MATERIALS AND METHODS: Urine samples were taken before, three hours, and six hours after intravenous administration of Gd-DTPA-BMA, Gd-DTPA, and Gd-DOTA at 0.2 ml/kg to five patients each who underwent contrast-enhanced MRI. Five patients who had non-contrast MRI were evaluated as controls. Urine was assayed for quantitative analysis of zinc and copper using atomic absorption analysis. RESULTS: Gd-DTPA-BMA caused the highest increase in zinc excretion among the three agents, 1,795 +/- 1,273 microg at 3 hours and 985 +/- 434 microg at 3 to 6 hours. Gd-DOTA did not cause a significant increase in zinc excretion, 75 +/- 39 microg at 3 hours and 78+/-65 microg at 3 to 6 hours. Gd-DTPA caused a moderate increase in zinc excretion, 665 +/- 240 microg at 3 hours and 378 +/- 173 microg at 3 to 6 hours. Excretion of copper did not show a significant difference among the three agents. CONCLUSION: Gd-DOTA was found to be the most kinetically inert among the three agents tested. The difference in zinc excretion among the MR contrast agents is possibly related to in-vivo transmetallation of the Gd chelate complexes correlated with variable stability of the contrast agents. The large amount of excess ligands contained in some MR contrast agents was also considered to be responsible for the increase of urinary zinc excretion.

Increased radiation dose by automatic exposure control system during fluoroscopy and angiography of pelvis due to contrast material in the bladder: experimental study.

PURPOSE: To evaluate the increase of radiation dose caused by contrast material excreted in the bladder during vascular interventional procedures of the pelvis. MATERIALS AND METHODS: A latex balloon filled with diluted contrast material, simulating the bladder, was placed in a water phantom. Entrance dose rates were measured under various conditions with and without the balloon. In animal experiments, skin doses during fluoroscopy and angiographic image acquisitions were measured at the pelvis of a swine before and after the contrast was excreted in the bladder. RESULTS: In phantom experiments, fluoroscopic dose rates increased 1.3- to 3.9-fold when the contrast-filled balloon was placed at the periphery of the phantom. The dose rates increased 3.0- to 4.0-fold when the balloon was placed at the center. In the animal experiment, dose rates increased 1.4- to 2.0-fold when the bladder was filled with contrast material. Skin doses during 10-second angiographic image acquisition also increased 1.1- to 2.3-fold when the bladder was filled with contrast. CONCLUSION: When the bladder is filled with excreted contrast material, skin doses delivered by fluoroscopy and angiography will increase. Removal of urine is recommended during vascular interventional procedures of the pelvis.

Comparison of I-123 IMP and Ga-67 citrate scintigraphy of malignant melanoma.

I-123 iodoamphetamine (IMP) and Ga-67 scintigraphy of malignant melanoma were performed to compare the accumulation of these tracers regarding tumor diameter to determine the site of I-123 IMP accumulation and to evaluate the use of I-123 IMP and Ga-67 in postoperative follow-up. The studies involved 44 patients with a definite diagnosis of malignant melanoma during a 10-year period from April 1991 through March 2001. In this study a very high detection rate of 90.9% was obtained for primary foci with I-123 IMP. With Ga-67, the primary site detection rate was 25%. The results suggest that I-123 IMP is superior to Ga-67 with respect to the detection rate of primary site.