Side-effects at phlebography with ionized and non-ionized contrast medium

Area of Science:

• Radiology
• Vascular Medicine
• Diagnostic Imaging

Background:

• Venous thrombosis diagnosis often involves phlebography.
• Contrast media used in phlebography can cause complications.
• Comparing the safety and efficacy of different contrast agents is crucial.

Purpose of the Study:

• To compare the safety and efficacy of metrizamide versus meglumine metrizoate for phlebography in patients with suspected venous thrombosis.
• To assess the incidence of provoked deep vein thrombosis and patient-reported symptoms associated with each contrast medium.

Main Methods:

• Two studies involving 267 patients with suspected venous thrombosis.
• Phlebography with either meglumine metrizoate (161 patients) or metrizamide (106 patients) as contrast medium.
• 125I-fibrinogen uptake test and rephlebography were used to assess outcomes.

Main Results:

• No significant difference in examination quality between the two contrast media.
• Meglumine metrizoate group reported more calf pain symptoms.
• 29 patients in the meglumine metrizoate group showed a significant rise in fibrinogen uptake post-procedure, suggesting provoked thrombosis.
• Rephlebography revealed fresh deep vein thrombosis in 7/9 patients who received meglumine metrizoate.
• Metrizamide group showed no significant increase in fibrinogen uptake or provoked thrombosis.
• Metrizamide has been used in ~400 patients without reported side-effects.

Conclusions:

• Metrizamide is a safer contrast medium for phlebography compared to meglumine metrizoate.
• Metrizamide significantly reduces the risk of provoked deep vein thrombosis and associated patient discomfort.
• Metrizamide is recommended for phlebography in suspected venous thrombosis cases.