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Effect of iodinated contrast media on blood clotting
C Corot1, J M Perrin, J Belleville
1Inserm U37, Bron, France.
Insights
Contrast media (CM) can affect blood clotting during angiography. Researchers found that iohexol and iopamidol prolonged clotting time, while ioxaglate, diatrizoate, and ioxitalamate inhibited it, preventing clot formation.
Area of Science:
- Biomedical Engineering
- Hematology
- Radiology
Background:
- Catheter-induced blood clot formation during angiography is a concern.
- Contrast media (CM) are suspected of activating hemostasis.
- However, CM may also possess anticoagulant and antiplatelet properties.
Purpose of the Study:
- To evaluate the impact of various nonionic and ionic CM on human whole blood clotting.
- To determine if CM influence hemostasis during angiography procedures.
Main Methods:
- Assessed the effect of five CM (iohexol, iopamidol, ioxaglate, diatrizoate, ioxitalamate) at 10% v/v in nonanticoagulated human whole blood.
- Measured fibrinopeptide A (FpA) generation kinetics to assess coagulation activation.
- Monitored blood clotting times in vitro.
Main Results:
- Two distinct groups of CM effects on blood clotting were identified.
- Iohexol and iopamidol demonstrated an increase in clotting time.
- Ioxaglate, diatrizoate, and ioxitalamate significantly inhibited clotting, with clotting times exceeding 30 minutes and no FpA generation.
Conclusions:
- Certain contrast media, specifically ioxaglate, diatrizoate, and ioxitalamate, exhibit potent anticoagulant properties.
- These findings suggest that CM choice may influence the risk of catheter-related thrombosis.
- Further investigation into CM-hemostasis interactions is warranted for interventional radiology safety.
Abstract:
Recently, blood clot formation in catheters used for the injection of nonionic contrast media (CM) during angiography has been reported as being due to activation of hemostasis in the catheter. However, CM exhibit inhibitory properties regarding coagulation and platelet functions. The effect on blood clotting of iohexol, iopamidol, ioxaglate, diatrizoate, and ioxitalamate at a ratio of 10% v/v with nonanticoagulated human whole blood was evaluated using the kinetics of fibrinopeptide A (FpA) generation. Blood aliquots were taken every 2 minutes until blood clot occurred. Two groups of contrast media were identified: (1) iohexol and iopamidol, which increased the clotting time, and (2) ioxaglate, diatrizoate, and ioxitalamate, for which all clotting times were over 30 minutes and no FpA generation occurred.