Myocardial ischemia during intravenous DSA in patients with cardiac disease.

Abstract

A prospective study was performed for 48 patients who had histories of angina and were referred for digital subtraction angiography (DSA). Cardiac disease was graded according to the American Heart Association (AHA) functional classification system. Each patient received 2-5 injections of 40-ml diatrizoate meglumine and diatrizoate sodium (Renografin-76, Angiovist-370, or MD-76) at 15 ml per second in the superior vena cava. Of the 28 patients in functional Classes I or II (no or slight limitation of activity), 11% had angina and 32% had definite ischemic ECG changes after the DSA injections. Of the 19 patients in functional Class III (marked limitation of activity), 63% had angina, and 58% had definite ischemic ECG changes after the injections. One patient in functional Class IV (total disability) developed ventricular fibrillation after the second injection. These observed cardiac effects following bolus injections of hypertonic ionic contrast media indicate that special precautions are necessary when performing intravenous DSA examinations on this group of high risk patients.

Cerebral angiographic risk in mild cerebrovascular disease.

“…The greater contrast load (70 g iodine) used routinely in IV-DSA than in conventional cerebral angiography (50 g) has particular implications in patients with borderline cardiac or renal reserve. 35 Nephrotoxicity was not specifically addressed in the studies reviewed, but a prospective study of changes in renal function over 72 hours after nonrenal angiography in 315 patients (131 aortoiliofemoral, 97 carotidvertebral, 87 splanchnic) has been reported. 36 In the 97 patients having carotid-vertebral angiography, serum creatinine concentration rose by 0.5-0.9 mg/dl (50-90 jtmol/l) in three patients and by >1.0 mg/dl (100 /xmol/1) (indicating acute renal failure) in one patient.…”

Remote loading of liposomes with a 124I-radioiodinated compound and their in vivo evaluation by PET/CT in a murine tumor model

“…In the present study, we report a new method for loading liposomes with an iodine-rich compound ( Figure 1 ). Diatrizoic acid, an iodinated CT contrast agent used clinically for visualization of, e.g., the bowel 40 and in digital subtraction angiography 41, was functionalized to carry a primary amine, enabling its remote loading into liposomes by a transmembrane pH gradient. While the unprotonated species may traverse the lipid membrane, protonation inside the liposome serves to trap it there.…”

Anomalous Origin of the Right Coronary Artery from the Ascending Aorta

“…Origin of the right coronary artery from the ascending aorta has been reported twice previously [6,7], When the origin of a coronary artery can not be demonstrated by direct injection, aor tography of the aortic root is helpful. Digital subtraction angiography has the advantage of requiring smaller doses of dilute contrast material, which may avoid the precipitation of congestive heart failure or acute ischemia in susceptible patients [8].' Also, the high resolution subtracted images are available for immediate inspection, and allow the pre cise diagnosis to be made in a single session.…”