iothalamate-meglumine and Gastrointestinal-Hemorrhage

The authors conducted a retrospective analysis of the CT findings in 29 consecutive patients being studied to detect complications of aortofemoral bypass surgery. Presenting symptoms included fever in 22 (76%), gastrointestinal bleeding in 2 (7%), a pulsating mass in 3 (10%), jaundice in 1 (3%), and back pain in 1 (3%). The complications observed most frequently were groin infection in 7 (24%), abdominal perigraft abscess in 11 (38%), pseudoaneurysm in 6 (21%), aortoenteric fistula in 3 (10%), and lymphocystic hematoma in 3 (10%). There were no false negatives, and the overall accuracy and sensitivity of CT in detecting complications was 100%. The authors recommend that CT be performed prior to angiography or surgery whenever an abscess, pseudoaneurysm, or aorto-enteric fistula is suspected.

Topics: Abscess; Aorta, Abdominal; Aortic Aneurysm; Blood Vessel Prosthesis; Femoral Artery; Fever; Gastrointestinal Hemorrhage; Humans; Iothalamate Meglumine; Postoperative Complications; Retrospective Studies; Surgical Wound Infection; Tomography, X-Ray Computed

Iopamidol, a new non-ionic water-soluble contrast medium, has been compared with standard ionic media in a number of cardiovascular applications. It is stable in aqueous solution, is much less viscous and only slightly more osmolar than metrizamide. Compared to sodium meglumine diatrizoate in a series of 40 coronary arteriograms, it produced a consistent and highly significant decrease in the incidence and severity of hypotension and bradycardia following intracoronary injection. In the same group and in 62 children undergoing ventricular or great vessel angiocardiography, a subjective assessment of patient reaction showed that iopamidol was better tolerated than the ionic medium. There was a very strong patient preference for iopamidol in a group of 20 of the adult patients who had also consented to femoral artery injections of both media. Throughout these series there was no detectable difference in arterial image quality between the media. Venous phase opacification during arterioportography was assessed in 11 cases comparing iopamidol with sodium meglumine iothalamate. No significant difference was found. We conclude that iopamidol is clearly preferable to ionic media for routine cardiovascular applications.

Topics: Angiocardiography; Child; Contrast Media; Coronary Disease; Diatrizoate Meglumine; Esophageal and Gastric Varices; Gastrointestinal Hemorrhage; Humans; Iopamidol; Iothalamate Meglumine; Iothalamic Acid; Portal Vein; Viscosity