Complications of phlebography: A randomised comparison between an ionic and a non-ionic contrast medium

Diagnosis of DVT

“…Finally, as many as one-third of patients with suspected recurrence have a venogram that is considered inadequate because of nonfi lling of venous segments. 169 In addition, as discussed in Section 2.0, venography is expensive, has complications, 13,40,[53][54][55][170][171][172] is not available in many centers, and cannot be completed in many patients for technical reasons.…”

Variable Effects of Radiological Contrast Media on Thrombus Growth in a Rabbit Jugular Vein Thrombosis Model

“…The conventional ionic high osmolar contrast medium inhibited thrombus growth, however, to a lesser extent than the ionic low osmolar contrast medium. These results may substantiate a possible prothrombotic effect of nonionic compared to ionic contrast media and could explain the clinically encountered thromboembolic complications after the use of nonionic low osmolar contrast media (5,7,8). However, proper clinical studies have to be performed to definitively assess differences in prevalence of post-procedural thromboembolic complications using various types of contrast media.…”

“…New generations of radiological contrast media with lower osmolality have recently been introduced for intravascular use and were considered to be superior to the conventional type of high osmolar contrast media in terms of general and toxic sideeffects (1)(2)(3). However, case reports and preliminary studies suggest that the use of low osmolar contrast media may be more frequently associated with thrombo-embolic complications after coronary angiography and venography (4)(5)(6)(7)(8) and simultaneous administration of anticoagulant drugs has been proposed (9). Specifically, post-procedural thrombosis seems to be related to the use of the nonionic low osmolar contrast media whereas the use of ionic low osmolar contrast media has less frequently been associated with these complications.…”

Recommendations from the ICM-VTE: General

“…Simultaneously, the invasiveness of phlebography related to the contrast injection as well as significant exposure to radiation, together with an improvement in the alternative methods nowadays limits the use of phlebography in daily practice. Beside the adverse effects related to phlebography performance, potential contraindications should also be mentioned, including contrast allergies as well as potential for renal impairment [1076][1077][1078] .…”