Iopamidol (B 15000), a nonionic water-soluble contrast medium for neuroradiology

Bacarini, L; Nicola, T. de; Gasparini, Daniele; Orlando, Paolo; Vassallo, A.

doi:10.1007/bf00367241

Cited by 12 publications

(2 citation statements)

References 6 publications

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“…Intravascular radiocontrast agents have been widely used in various diagnostic procedures. 10,11,20,26,31,41,45,69,88,95,96,129,138,169,181,188 Numerous re ports on varying degrees of adverse reactions during and after their use have been published. [2][3][4]19,21,24,25,40,43,44,46,66 These reactions can be classified as minor, intermediate, and severe and are listed in Figure 23.…”

Section: Discussionmentioning

confidence: 99%

Molecular Markers of Contrast Media-Induced Adverse Reactions

Fareed¹,

Moncada²,

Messmore³

et al. 1984

Semin Thromb Hemost

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Currently used routine laboratory screening methods are not reliable in the prediction of contrast media-related adverse reactions. Cost-effective laboratory methods for various molecular markers of pathophysiologic activation have now become available. In vitro activation tests in high-risk patients may prove to be useful in the prediction of contrast-induced activation of various adverse reactions. If prior clinical evaluation of a patient suggests an ongoing pathologic process, profiling of the following molecular markers may prove to be useful and helpful in avoiding contrast-induced adverse reactions: Fibrinopeptide A, platelet factor 4, thromboxane B2, 5-HETE, physiologic inhibitors of proteases, B beta 15-42 related peptides, bradykinin/kininogen, and anaphylactozins. In patients suspected of reacting to contrast agents, a small dose of 1 to 5 ml can be injected as a bolus and molecular marker profiling on blood drawn after the infusion may prove to be useful screening tests. Additional clinical studies are needed to prove this. However, this screening test should be performed with extreme caution, since some of the patients are known to react to as little as 1 ml dose. The safety of newly developed nonionic contrast agents can be readily assessed by profiling various molecular markers of adverse reactions, which provide a more reliable and quantitative assessment of contrast-induced adverse reactions. Based on molecular marker profiling, various prophylactic agents can be given to high-risk patients to avoid contrast-induced adverse reactions.

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Section: Discussionmentioning

confidence: 99%

Molecular Markers of Contrast Media-Induced Adverse Reactions

Fareed¹,

Moncada²,

Messmore³

et al. 1984

Semin Thromb Hemost

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“…Although animal studies have shown iopamidol to be more epileptogenic than metrizamide 45 and the excitative neurotoxic potential of iodixanol, 46 clinical trials of these newer nonionic agents have shown them to be safe and effective, with fewer adverse effects than metrizamide. 8,16,22,47 The risk of seizure with the currently used contrast media is reported to be in the range of 0.093%-0.847%. 19,48 Review of the literature revealed only case reports of seizure activity after myelography with iopamidol 13,21 and iohexol (On-line Table 3).…”

Section: Discussionmentioning

confidence: 99%

Critical Assessment of Myelography Practices: A Call for Rational Guideline Revision

Shah

Kranz

Anzai

et al. 2018

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: Patient preparation for myelography and postprocedural monitoring varies widely between practices, despite published guidelines. Our aim was to examine the current practice variations in discontinuing reportedly seizure thresholdlowering medications before myelography and to assess the reported incidence of postmyelographic seizures. MATERIALS AND METHODS: An e-mail survey was sent to American Society of Neuroradiology members concerning the number of postmyelographic seizures experienced in the past 5 years, the presence of an institutional policy for discontinuing seizure threshold-lowering medications, and the type of myelographic contrast used. We compared the postmyelographic seizure frequency in the responses. RESULTS: Of 700 survey responses, 57% reported that they do not discontinue seizure threshold-lowering medications before myelography. Most (97%) indicated never having a patient experience a seizure following myelography. The number of postmyelographic seizures between those who discontinue seizure threshold-lowering medications and those who do not was not statistically significant (OR ϭ 2.13; 95% CI, 0.91-4.98; P ϭ .08). Most (95%) reported using nonionic hypo-osmolar agents. CONCLUSIONS: Survey results revealed widely variable practices for patient myelography preparation and postprocedural monitoring. We found no difference in reported seizures between those who discontinued seizure threshold-lowering medications and those who did not. In light of our findings, we propose that discontinuing reportedly seizure threshold-lowering medications is not warranted with the current nonionic water-soluble contrast agents and may be potentially harmful in some instances. This work supports revision of existing recommendations to withhold such medications before myelography.

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Seizures following myelography with iopamidol

Levey

Weiss

et al. 1988

Annals of Neurology

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Iopamidol, a water-soluble contrast medium, has been rarely associated with seizures. We describe 3 patients (from a series of 785) who had generalized tonic-clonic seizures after iopamidol myelography. Two of the patients underwent lumbar and one cervical myelography. There was a history of seizures in 2 patients, and the dose of iopamidol used in the patients who convulsed was high, ranging from 3,000 to 4,500 mg iodine. Despite the reported low incidence of complications with iopamidol, seizures may occur, especially in patients with previous seizures and also in those receiving higher doses of iopamidol.

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Iopamidol (B 15000), a nonionic water-soluble contrast medium for neuroradiology

Cited by 12 publications

References 6 publications

Molecular Markers of Contrast Media-Induced Adverse Reactions

Molecular Markers of Contrast Media-Induced Adverse Reactions

Critical Assessment of Myelography Practices: A Call for Rational Guideline Revision

Seizures following myelography with iopamidol

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