meglumine-ioglicinate and ioxitalamic-acid

The image contrast quality and the patient tolerance of two osmotically active water-soluble contrast agents were examined and compared in double blind study cerebral angiography: Rayvist (an Ioglicinate developed recently) and Telebrix (AN Ioxithalamate). In 100 direct carotid or retrograde brachial angiograms the tolerance of Rayvist was significantly better, primarily because of less subjective patient side effects and less frequent cardiovascular reactions. However, there was no significant difference in neurological complications or deterioriation of EEG-findings, both quite rare anyway.

Topics: Adult; Aged; Cerebral Angiography; Clinical Trials as Topic; Contrast Media; Double-Blind Method; Female; Humans; Iothalamic Acid; Male; Meglumine; Middle Aged

Routine clinical use of radiographic contrast media (RCM) causes adverse reactions in some patients. To elucidate the mechanisms of these reactions both in vitro and in vivo studies are necessary. In this study, RCM-induced histamine release from isolated mast cells was compared with the in vivo release of histamine and cardiovascular symptoms using a porcine model. The 2 non-ionic preparations examined (Solutrast and Ultravist) released little or no histamine from the 4 cell types tested (porcine pulmonary, cardiac, hepatic, and renal mast cells). The 4 ionic preparations (Angiographin, Hexabrix Rayvist, and Telebrix) caused histamine release from most of the cell suspensions. In almost all cases, the cardiac mast cells were the most sensitive followed by the hepatic mast cells. All 4 RCM tested in vivo produced elevated plasma histamine levels in some animals. The highest incidence was observed using the ionic, high osmolal Rayvist (6 of 12 animals), followed by the non-ionic RCM with the lowest osmolality Ultravist (4 of 12 animals). In vivo, mechanisms in addition to direct histamine release may also be involved in RCM-induced adverse reactions, since low osmolal, non-ionic RCM can cause elevated plasma histamine levels without in vitro release. The susceptibility of cardiac mast cells to RCM-induced histamine release suggests that patients undergoing e.g. coronary angiography may be especially at risk for an adverse reaction.

Topics: Animals; Contrast Media; Female; Histamine; Histamine Release; Iohexol; Iopamidol; Iothalamic Acid; Kidney; Liver; Lung; Male; Mast Cells; Myocardium; Swine