Hexabrix--a new contrast medium in angiocardiography

Area of Science:

• Radiology and Imaging
• Cardiovascular Medicine
• Medical Contrast Agents

Background:

• Ionic angiographic media exhibit high osmolality, leading to adverse patient effects.
• Metrizamide, an early low-osmolality agent, faced limitations due to cost and preparation requirements.

Purpose of the Study:

• To evaluate Hexabrix, a novel low-osmolality ionic contrast medium available in stable solution.
• To compare the safety and efficacy of Hexabrix against established ionic and low-osmolality contrast agents in angiocardiography.

Main Methods:

• Direct comparison of Hexabrix with Urografin, Triosil, Cardio-Conray, and metrizamide in angiocardiographic procedures.
• Assessment of patient-reported discomfort and tolerance, particularly in pediatric cases.
• Evaluation of cardiac and hemodynamic effects, including T wave changes and heart rate variations, during coronary angiography.

Main Results:

• Low-osmolality media, including Hexabrix, demonstrated significantly less patient discomfort than ionic media.
• Hexabrix and other low-osmolality agents were better tolerated in pediatric angiocardiography.
• In coronary angiography, Hexabrix showed comparable T wave changes to Urografin and less than Triosil or metrizamide, with a trend towards less heart rate impact.
• A reduced risk of exacerbating pulmonary arterial hypertension was observed with Hexabrix in right heart angiography.

Conclusions:

• Hexabrix offers a clinically advantageous low-osmolality contrast medium due to its stable solution formulation.
• Low-osmolality contrast media represent a significant advancement in improving patient safety and comfort during angiocardiography.
• Hexabrix shows a favorable profile in terms of hemodynamic effects and potential for pulmonary hypertension exacerbation.