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Contrast media effects on hemostatic and thrombotic parameters. Possible consequences for practical techniques and
H Stormorken1, K S Sakariassen
1Nyocomed Bioreg AS, Oslo, Norway.
Acta Radiologica. Supplementum
|January 1, 1995
Summary
Contrast media (CM) impact blood clotting differently. Ionic CM strongly inhibits coagulation and platelets but harms endothelium, while nonionic CM has weaker effects, influencing thromboembolic events in procedures like angioplasty.
Area of Science:
- Cardiovascular Medicine
- Hematology
- Radiology
Background:
- The thrombohemorrhagic balance is crucial for hemostasis and thrombosis.
- Contrast media (CM) are widely used in medical imaging and interventions, potentially affecting this balance.
Purpose of the Study:
- To review the mechanisms by which contrast media influence thrombohemorrhagic processes.
- To evaluate the clinical implications of these interactions, particularly in percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass grafting (CABG).
Main Methods:
- Review of existing literature on the effects of ionic and nonionic contrast media on coagulation and platelet function.
- Analysis of clinical observations regarding thromboembolic events associated with different CM types during PTCA and CABG.
Main Results:
- Ionic CM strongly inhibit coagulation and platelet function and are more detrimental to endothelium than nonionic CM.
- Some studies suggest a lower incidence of thromboembolic events with ionic CM in PTCA/CABG, though this does not impact mortality or need for reintervention.
- Effective antithrombotics are needed to manage these events, with aggressive anti-atherogenic prophylaxis potentially beneficial.
Conclusions:
- Contrast media exert differential effects on the thrombohemorrhagic balance.
- Current antithrombotic strategies may require optimization, and the ideal agent for preventing CM-related thromboembolic events remains elusive.
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