Iomeprol

Dooley, Mukta; Jarvis, Blair

doi:10.2165/00003495-200059050-00013

Cited by 34 publications

(9 citation statements)

References 44 publications

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“… 38 Our patient suffered an ischemic stroke several days before the cerebral angiography was performed, so a pre-existing disruption of the blood–brain barrier could be a reasonable possibility. Even if Iomeprol is a nonionic, monomeric iodinated contrast medium with lower osmolality and viscosity, and higher water solubility as compared with other nonionic contrast agents, 40 being currently considered one of the contrast agents with the lowest risk of neurotoxicity, 38 we cannot rule out a direct toxic effect of the contrast agent on the hippocampal CA-1 neurons leading to transient global amnesia in our patient.…”

Section: Discussionmentioning

confidence: 82%

Transient Global Amnesia After Cerebral Angiography With Iomeprol

Tiu

Terecoasa

Grecu³

et al. 2016

Medicine

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Transient global amnesia is now considered a very rare complication of cerebral angiography. Various etiological mechanisms have been suggested to account for this complication, but no consensus has been reached yet. This case report documents one of the few reported cases of cerebral angiography-related transient global amnesia associated with magnetic resonance imaging (MRI) evidence of unilateral hippocampal ischemia, most probably as a consequence of a transient reduction in regional hippocampal blood flow. However, the possibility of a direct neurotoxic effect of the nonionic contrast media Iomeprol on the Cornu ammonis – field 1 neurons cannot be firmly ruled out.We describe the case of a 54-year-old woman admitted to our department for left upper limb weakness with acute onset 8 days before. The brain computed tomography (CT) scan performed at admission revealed subacute ischemic lesions in the right watershed superficial territories and a right thalamic lacunar infarct. Diagnostic digital subtraction cerebral angiography was performed 4 days after admission with the nonionic contrast media Iomeprol. A few minutes after completion of the procedure, the patient developed symptoms suggestive for transient global amnesia. The brain MRI performed 22 hours after the onset of symptoms demonstrated increased signal within the lateral part of the right hippocampus on the diffusion-weighted imaging (DWI) sequences, associated with a corresponding reduction in the apparent diffusion coefficient (ADC) and increased signal on the fluid-attenuated inversion recovery (FLAIR) sequences, consistent with acute hippocampal ischemia and several T2/FLAIR hyperintensities in the right watershed superficial territories and in the right thalamus, corresponding to the lesions already identified on the CT scan performed at admission. A follow-up MRI, performed 2 months later, demonstrated the disappearance of the increased signal within the right hippocampus on the DWI, T2/FLAIR, and ADC sequences.The precise mechanism of transient global amnesia related to cerebral angiography is still unclear, and further studies aimed to determine the definite pathophysiology of this syndrome and consequently to establish specific preventive measures are needed. Although the condition itself is considered to be self-limited, the long-term prognosis and the risk of recurrence in the cases where subsequent angiographic procedures are performed are not established yet.

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Section: Discussionmentioning

confidence: 82%

Transient Global Amnesia After Cerebral Angiography With Iomeprol

Tiu

Terecoasa

Grecu³

et al. 2016

Medicine

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“…Molecular chemotoxicity decreases as the number of carboxyl groups decreases and the number of hydroxyl groups increases, and IRCM with no carboxyl groups and a number of hydroxyl groups evenly distributed around the main molecule have reduced neurotoxicity. 60,61 Iodixanol has an increased number of hydroxyl groups (n ϭ 9) compared with LOCM (eg, 5 for iopamidol), but more carboxy groups (6 versus 3), theoretically disadvantageous in human use. Increasing the number of hydroxyl groups also increases solubility, thus reducing the tendency to bind to tissues and proteins, which may then lead to inhibition of enzyme systems, including acetylcholinesterase.…”

Section: Discussionmentioning

confidence: 99%

Outcome Differences between Intra-Arterial Iso- and Low-Osmolality Iodinated Radiographic Contrast Media in the Interventional Management of Stroke III Trial

Tomsick¹,

Foster²,

Liebeskind³

et al. 2015

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:Intracarotid arterial infusion of nonionic, low-osmolal iohexol contrast medium has been associated with increased intracranial hemorrhage in a rat middle cerebral artery occlusion model compared with saline infusion. Iso-osmolal iodixanol (290 mOsm/kg H 2 O) infusion demonstrated smaller infarcts and less intracranial hemorrhage compared with low-osmolal iopamidol and saline. No studies comparing iodinated radiographic contrast media in human stroke have been performed, to our knowledge. We hypothesized that low-osmolal contrast media may be associated with worse outcomes compared with iodixanol in the Interventional Management of Stroke III Trial (IMS III).

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“…This shows that both nausea and dizziness also occurs in the groups not receiving contrast media. In a review by Dooley et al [21], the overall incidence of AAEs and discomfort (metal taste, warmth, local pain etc.) of CT contrast medium iomeprol ranged from 3% -49.7%.…”

Section: Discussionmentioning

confidence: 99%

Acute non-renal adverse events after unenhanced and enhanced computed tomography and magnetic resonance imaging

Azzouz¹,

Rømsing²,

Thomsen³

2013

OJCD

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Aim: Investigating the incidence of non-renal acute adverse events (AAEs) in patients undergoing unenhanced or enhanced computed tomography (CT) or magnetic resonance (MR) (four groups) using the active interview-method. Methods: The imaging procedure followed the standards of the department. Furthermore, the iodine-based (nonionic monomer) and gadolinium-based (cyclic) contrast agent was the same as used for all other examinations in the department. All patients were interviewed for 72 hours after the MR or CT examination regarding occurrence of AAEs using a structured questionnaire. Results: A total of 1358 patients (259 with enhanced MR, 434 with unenhanced MR, 450 with enhanced CT and 215 with unenhanced CT) were enrolled. AAEs were significantly higher (P < 0.05) in the contrast enhanced MR [48 (18.5%)] and CT [35 (7.7%)] groups compared to unenhanced MR [39 (9.0%)] and CT [5 (2.3%)] groups. Dizziness was significantly [19 (7.3%), (P < 0.05)] more frequent in the enhanced MR. The same AAEs were reported in both contrast groups and control groups. Conclusion: AAEs which are mainly considered to be caused by the contrast medium are also experienced by patients undergoing CT or MR without contrast. Enhanced MR is correlated with more reactions than unenhanced MR and enhanced CT. Dizziness was reported more frequently after MR than CT, both with and without contrast; more patients were CNS examined with MR and with CT.

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Iomeprol

Cited by 34 publications

References 44 publications

Transient Global Amnesia After Cerebral Angiography With Iomeprol

Transient Global Amnesia After Cerebral Angiography With Iomeprol

Outcome Differences between Intra-Arterial Iso- and Low-Osmolality Iodinated Radiographic Contrast Media in the Interventional Management of Stroke III Trial

Acute non-renal adverse events after unenhanced and enhanced computed tomography and magnetic resonance imaging

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