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Cerebral thromboembolic complications associated with the use of a nonionic contrast medium in coronary angiography
K Levorstad1, K Vatne, U Brodahl
1Department of Diagnostic Radiology, National Hospital, University of Oslo, Norway.
Insights
Cerebrovascular complications occurred in 0.21% of patients undergoing coronary angiography. After excluding high-risk individuals, the incidence of cerebral thromboembolic events was 0.10%, highlighting the importance of procedural precautions.
Area of Science:
- Cardiology
- Neurology
- Radiology
Background:
- Coronary angiography is a common procedure.
- Cerebrovascular complications are a potential risk.
- Nonionic contrast media like iohexol are frequently used.
Purpose of the Study:
- To determine the incidence of cerebrovascular complications during coronary angiography.
- To assess the role of the nonionic contrast medium iohexol in these events.
- To identify risk factors and preventive measures.
Main Methods:
- Retrospective analysis of 5,339 patients undergoing coronary angiography.
- Use of nonionic contrast medium iohexol (Omnipaque).
- Identification and exclusion of patients with predisposing conditions for thromboembolism.
Main Results:
- 11 patients (0.21%) experienced cerebrovascular complications.
- Six patients had predisposing conditions; 3 had prior stroke symptoms.
- Excluding these 6, the incidence of cerebral thromboembolic events was 0.10%.
Conclusions:
- Cerebrovascular complications are rare during coronary angiography with iohexol.
- Precise catheterization technique and anticoagulation/antiplatelet therapy are crucial for prevention.
- The specific role of iohexol in these complications requires further investigation.
Abstract:
Cerebrovascular complications were registered in 11 patients (0.21%) of 5,339, consecutively submitted to coronary angiography with the nonionic contrast medium iohexol (Omnipaque). Six of the patients had diseases predisposing them to thromboembolic complications, 3 of whom earlier had symptoms of cerebral stroke. Excluding these 6, the incidence of cerebral thromboembolic events was 0.10% in patients with no predisposing diseases. Precise catheterization technique and some anticoagulation and antiplatelet activity therapy are definite precautions against these complications, while the role of the contrast medium is still debated.
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