A comparison of iodixanol with iopamidol in aorto-femoral angiography

Abstract

This double-blind, randomized, parallel group clinical investigation in 140 consecutive patients undergoing aorto-femoral arteriography was carried out to compare iodixanol (Visipaque) 270 mgI ml-1 with iopamidol (Iopamiro) 300 mgI ml-1. The aims of the study were to compare adverse events and discomfort, clinical chemistry parameters in blood, haemodynamics and diagnostic information of the angiograms in the two groups. The main parameter for statistical analysis was the visual analogue scale (VAS) score for overall discomfort experienced by the patients during the examination. 134 patients, 69 and 65 receiving iodixanol and iopamidol, respectively, were examined according to the protocol and included in the evaluation. The two groups of patients were judged to be comparative. Statistically significant milder discomfort was felt with iodixanol than with iopamidol (p = 0.0001); mean VAS values 16 mm and 51 mm, respectively. Pain was reported far less frequently after iodixanol than after iopamidol (7.4% versus 50.8%) whereas sensation of warmth was less intense after iodixanol than after iopamidol. Four patients in the iodixanol group and two in the iopamidol group reported transient, non-serious adverse events. The difference was not statistically significant (p = 0.68). Systolic blood pressure was affected to a slightly greater degree after injection of iopamidol than after injection of iodixanol. Measurements of diastolic blood pressure, as well as clinical chemistry parameters in blood, revealed no changes of clinical importance, and all arteriograms performed were of diagnostic value. The conclusion is that iodixanol 270 mgI ml-1 is as efficacious as iopamidol 300 mgI ml-1, but produces less discomfort during arteriography. As such, iodixanol is a good alternative to iopamidol in aorto-femoral angiography.

Coronary stent evaluation with coronary computed tomographic angiography: Comparison between low-osmolar, high-iodine concentration iomeprol-400 and iso-osmolar, lower-iodine concentration iodixanol-320

“…11 Our findings in relation to contrast tolerability and symptoms are consistent with findings by Svensson et al 7 which showed that iodixanol-320 injection was associated with less heat sensation compared with iomeprol-400 in patients undergoing MDCT-CA 7 and with 2 other studies showing that leg pain was reduced during femoral arteriography performed with iodixanol compared with 2 low-osmolar CM. 12,13 With regard to the lower number of slice misalignment artifacts with iodixanol, our results indicate that this was likely because of the reduction of arrhythmias and more stable HR during the scan after iodixanol-320 administration. This is in agreement with the study by Svensson et al 7 which reported a reduction of PHBs with iodixanol-320 compared with iomeprol-400 during MDCT-CA and with other clinical and animal studies that showed fewer electrophysiological changes and proarrhythmic effects of iodixanol-320 than of low-osmolar agents that were attributed to the electrolyte composition of the isoosmolar CM.…”

A Meta-Analysis of the Renal Safety of Isosmolar Iodixanol Compared With Low-Osmolar Contrast Media

“…According to this result, the fixed effects model was chosen to test the overall effect. The test for the overall effect showed a significant difference in favor of the group receiving IOCM, with the odds ratio (OR) ϭ 0.39, 95% confidence interval (CI) 0.23 to 0.66, p ϭ 0.0004 (19,20,25,26,30,(32)(33)(34)(35)(36). Heterogeneity test for trials in which at least 1 patient experienced CIN (10 of 16), and test for the overall effect with trials weighted according to the Mantel-Haenszel method, with the Review Manager 4.2.7. n ϭ number of patients who experienced CIN defined as Cr increase Ն0.50 mg/dl; N ϭ number of patients with Cr measurements; PTCA ϭ percutaneous transluminal coronary angioplasty (trial [25]); other abbreviations as in Figure 1.…”

Contrast-Induced Acute Kidney Injury: Specialty-Specific Protocols for Interventional Radiology, Diagnostic Computed Tomography Radiology, and Interventional Cardiology

“…23,24 Several studies that have compared the tolerability of the iso-osmolar contrast medium iodixanol with that of lowosmolar contrast medium report that iso-osmolar contrast medium is associated with a decrease in the intensity of discomfort (heat sensations) and pain. [24][25][26][27][28][29][30] Overall, the key issue that becomes important to define for each specialty is the degree of risk that makes the effort needed to screen patients, identify those at risk, and then implement prevention strategies, a requirement despite any impracticality.…”