Renal-related adverse effects of intravenous contrast media in computed tomography

Leow, Kheng Song; Wu, Yi Wei; Tan, Cher Heng

doi:10.11622/smedj.2015057

Cited by 16 publications

(23 citation statements)

References 68 publications

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“…There are distinct types of complications following intravenous use: soft tissue injury, direct chemical toxicity, nephrotoxicity, and anaphylactic reactions (Leow et al 2015 ; Li et al 2015 ; McAlister and Kissane 1990 ). Nearly 2 % of the patients in this study experience adverse reactions related with intravenous contrast medium, similar to the dictation of Ho et al (Ho et al 2007 ).…”

Section: Discussionmentioning

confidence: 99%

Safety enhancement in adult body computed tomography scanning: comparison of iodixanol versus iohexol

Xiao

Zeng

et al. 2016

SpringerPlus

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BackgroundThe aim of this study was to compare the safety and intra-individual contrast enhancement of low-osmolar monomeric iohexol and the iso-osmolar dimeric iodixanol in body computed tomography (CT) scanning.MethodsIn this single center, double-blind, prospective study, a total of 2000 consecutive patients undergoing adult body CT scanning were prospectively enrolled, with 1000 patients assigned to iodixanol and 1000 patients assigned to iohexol. In both groups, the contrast medium was injected at the rate of 3.5 ml/s. Subjective assessment of image quality for each image was determined using a 3-grading scale by three reviewers. Patients were monitored with questioning and vital signs before injection, immediately after injection, and at 24 and 48 h. Extensive laboratory evaluation also was performed.ResultsLaboratory results showed no significant difference across groups. There were also no detectable differences in image quality between the two contrast groups in this study. The total adverse reactions occurred in less than 1 % of individuals receiving iodixanol comparing to 2.5 % in iohexol group (P < 0.05). Among them, only 0.7 % patients injecting iodixanol suffered immediate events, comparing to 2 % patients in iohexol group. In all, 0.2 % patients with iodixanol and 0.5 % with iohexol had late allergic reaction. Further, No deaths occurred in any of the two groups.ConclusionsThe iso-osmolar iodixanol provides image quality compared with that of iohexol, with lower incidence of adverse events.

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Section: Discussionmentioning

confidence: 99%

Safety enhancement in adult body computed tomography scanning: comparison of iodixanol versus iohexol

Xiao

Zeng

et al. 2016

SpringerPlus

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“…It was found that the oxidation current peak of AA at 600 mV effected on the redox current peaks of the contrast medium, causing the disappearance of anodic (oxidation) current peak of the contrast medium and the enhancement of cathodic (reduction) current peak at -900 mV. Hence, AA acted as an electrocatalyst reagent for safely using gadolinium compounds in blood medium [26][27][28][29].…”

Section: Effect Of Gadolinium Compound In Blood Mediummentioning

confidence: 99%

New Voltammetric Study of MgCl2 as Alternative Contrast Media in MRI Molecular Imaging

Radhi¹,

Al-Shimmari²,

Al-Mulla³

et al. 2017

Nano BioMed ENG

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Gadolinium compounds have been used as a common contrast media in MRI technique; however, they have oxidation-reduction current peaks in blood medium. To propose a solution for this problem, the alternative of contrast media in magnetic resonance imaging (MRI) was studied by electrochemical method using cyclic voltammetric technique. Magnesium compound was chosen such as MgCl 2 which has a good electrochemical properties especially in blood medium. It was found that Mg (II) ions in blood medium acted as an antioxidative reagent. The results of this study focused on the effect of magnesium chloride ions in normal saline, KCl solution and blood medium in presence with ascorbic acid (AA) and folic acid (FA) and understanding the redox current peaks of Mg (II) ions in these conditions. We obtained good results by using MgCl 2 solution as an alternative contrast medium in MRI technique instead of using of gadolinium compounds.

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“…As such, it may be useful to guide valve selection in low-resource settings where access to MSCT or TEE technology is limited. Furthermore, given that only a fraction of the contrast agent used for MSCT was required for CA, the latter approach may be an interesting alternative for patients at high risk of contrast-induced nephropathy 28. As always, a balance must be struck between the risks and benefits of each technique.…”

Section: Discussionmentioning

confidence: 99%

Utility of conventional aortic root shot angiography for SAPIEN 3 prosthesis sizing in TAVI: feasibility and inter-reader variability

et al. 2019

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BackgroundThe gold-standard approach to prosthesis sizing before transcatheter aortic valve implantation (TAVI) is multislice computed tomography (MSCT). We aimed to investigate whether conventional aortic root angiography (CA) alone can reliably facilitate valve selection and to describe its inter-reader variability.MethodsFive TAVI specialists (3 interventional cardiologists and 2 cardiac surgeons) independently reviewed preprocedural CAs for 50 patients implanted with the Edwards SAPIEN 3 valve.ResultsThe prosthesis size selected based on visual CA appraisal matched that based on MSCT in 60% of cases (range: 50%–68%), with undersizing in 11% (4%–33%) and oversizing in 29% (10%–46%; p=0.187 for equality of the proportions test). Agreement between CA-based and MSCT-based valve selection was moderate (K=0.41; Kw=0.61). Reassessment of choice following awareness of the annulus long-axis diameter did not significantly improve this agreement (0.40 and 0.63, respectively), though more undersizing (14%) and less oversizing (25%) occurred. Correct valve selection was more common in interventional cardiologists than cardiac surgeons (66% vs 53%; p=0.0391), who made more oversizing errors.ConclusionsThere is a modest agreement between CA-based and MSCT-based SAPIEN 3 selection. Although the former should not be performed routinely, it may be informative in settings where MSCT and transoesophageal echocardiography are unavailable.

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Renal-related adverse effects of intravenous contrast media in computed tomography

Cited by 16 publications

References 68 publications

Safety enhancement in adult body computed tomography scanning: comparison of iodixanol versus iohexol

Safety enhancement in adult body computed tomography scanning: comparison of iodixanol versus iohexol

New Voltammetric Study of MgCl2 as Alternative Contrast Media in MRI Molecular Imaging

Utility of conventional aortic root shot angiography for SAPIEN 3 prosthesis sizing in TAVI: feasibility and inter-reader variability

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