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European Radiology

, 16:2721 | Cite as

Effects of iodinated contrast media on common carotid and brachial artery blood flow and wall shear stress

  • C. IraceEmail author
  • S. Tamburini
  • B. Bertucci
  • M. S. De Franceschi
  • A. Gnasso
Contrast Media

Abstract

The aim of our study was to evaluate the effect of the intravenous contrast media iomeprol on wall shear stress, blood flow and vascular parameters in the common carotid and brachial artery. Thirty outpatients undergoing thoracic or abdominal spiral CT scans were studied. The internal diameter and flow velocity of the common carotid and brachial artery were evaluated by ultrasound, and blood viscosity was measured before and after low osmolality iomeprol (Iomeron 350) injection. The wall shear stress, blood flow and pulsatility index were calculated. To test the differences between groups, the Wilcoxon rank test and Mann Whitney U test were applied. Blood viscosity decreased slightly, but significantly after contrast media (4.6±0.7 vs. 4.5±0.7 mPa.s, P=0.02). Contrarily, blood flow and wall shear stress did not change in the common carotid artery, but significantly decreased in the brachial artery (0.9±0.4 vs. 0.6±0.3 ml/s, P<0.0001, and 41.5±13.9 vs. 35.3±11.0 dynes/cm2, P<0.002, respectively), whereas the pulsatility index significantly increased in the brachial artery (5.0±3.3 vs. 7.5±5.3, P<0.001). Iomeprol injection causes blood flow and wall shear stress reduction of the brachial artery; the rise in the pulsatility index suggests an increase in peripheral vascular resistance. Further investigation is needed to evaluate whether these modifications can be clinically relevant.

Keywords

Contrast media Ultrasound Blood flow 

References

  1. 1.
    Baile EM, Parè PD, D’yachkova Y, Carere RG (1999) Effects of contrast media on coronary vascular resistances. Chest 116:1039–1045PubMedCrossRefGoogle Scholar
  2. 2.
    Pugh ND, Karlsson JOG (1997) Vasodilator and hemorheological effects of iodinated contrast media. Drugs of Today 33:191–203Google Scholar
  3. 3.
    Morcos SK, Dawson P, Pearson JD, Jeremy JY, Davenport AP, Yates MS, Cipolla TP, de Haen C, Muschick P, Krause W, Refsum H, Emery CJ, Liss Nygren A, Haylor J, Pugh ND, Karlsson JO (1998) The haemodynamic effects of iodinate water soluble radiographic contrast media: a review. Eur J Radiol 29:31–46PubMedCrossRefGoogle Scholar
  4. 4.
    Limbruno U, Caterina RD (2003) Vasomotor effects of iodinate contrast media: just side effect? Curr Vasc Pharmacol 1:321–328PubMedCrossRefGoogle Scholar
  5. 5.
    Strickland NH, Rampling MW, Dawson P, Martin G (1992) Contrast media-induced effects on blood rheology and their importance in angiography. Clin Radiol 45:240–242PubMedCrossRefGoogle Scholar
  6. 6.
    Krystal GJ, Salem MR (1996) Investigations into the mechanisms of coronary vasodilation. Invest Radiol 31:556–562CrossRefGoogle Scholar
  7. 7.
    Lloyd DA, Stein JS, Rowe MI (1990) The effects of a hyperosmolar intravenous contrast medium on blood viscosity. Investig Radiol 26:220–223CrossRefGoogle Scholar
  8. 8.
    Gustavsson CG, Persson SU, Larsson H, Persson S, Thorvinger BOS (1996) Vein blood rheology alterations immediately after coronary angiography with iohexol, and one month later. Clin Hemorheol 16:737–743Google Scholar
  9. 9.
    Aliev G, Obrenovich ME, Seyidova D, Rzayev NM, Aliyev AS, Raina Ak, Lamanna JC, Smith MA, Perry G (2003) X-Ray contrast media induce aortic endothelial damage, which can be prevented with prior heparin treatment. J Submicrosc Cytol Pathol 35:253–266PubMedGoogle Scholar
  10. 10.
    Karstoft J, Baath L, Jansen I, Edvinsson L (1995) Contrast medium-induced vasoconstriction. An investigation of the vasoconstrictive action of iohexol in isolated rabbit coronary arteries. Acta Radiol 36:198–203PubMedCrossRefGoogle Scholar
  11. 11.
    Olroyd S, Haylor JL, Morcos SK (1995) Bosentan, an orally active endothelin antagonist: effect on renal response to contrast media. Radiology 196:661–665Google Scholar
  12. 12.
    Morkos SK, Olroyd S, Haylor JL (1997) Effect of radiographic contrast media on endothelium derived nitric oxide-dependent renal vasodilatation. Br J Radiol 70:154–159Google Scholar
  13. 13.
    Liss P, Nygren A, Olsson U, Ulfendahl HR, Erikson U (1996) Effect of contrast media and mannitol on renal medullary blood flow and red cell aggregation in the rat kidney. Kidney Int 49:1268–1275PubMedGoogle Scholar
  14. 14.
    Gnasso A, Carallo C, Irace C, Spagnuolo V, De Novara G, Mattioli PL, Pujia A (1996) Association between intima-media thickness and wall shear stress in the common carotid arteries in healthy male subjects. Circulation 94:3257–3262PubMedGoogle Scholar
  15. 15.
    Sorensen KE, Celermajer DS, Spiegelharter DJ, Georgakopoulos D, Robinson J, Thomas O et al (1995) Non-invasive measurement of human endothelium dependent arterial responses: accuracy and reproducibility. Br Heart J 74:247–253PubMedGoogle Scholar
  16. 16.
    Verma S, Buchanan M, Anderson TJ (2003) Endothelial function testing as a biomarker of vascular disease. Circulation 108:2054–2059PubMedCrossRefGoogle Scholar
  17. 17.
    Lo Russo V, Taroni P, Alvino S, Spinazzi A (2001) Pharmacokinetics and safety of iomeprol in healthy volunteers and in patients with renal impairment or end-stage renal disease requiring hemodialysis. Investig Radiol 36:309–316CrossRefGoogle Scholar
  18. 18.
    Limbruno U, Petronio AS, Amoroso G, Baglini R, Paterni G, Merelli A, Mariottti R, De Caterina R, Mariani M (2000) The impact of coronary artery disease on the coronary vasomotor response to nonionic contrast media. Circulation 101:491–497PubMedGoogle Scholar
  19. 19.
    Wellnhofer E, Dreysse S, Fleck E (2001) Is contrast-related vasodilatation after intracoronary iodixanolo and iopromide in vivo endothelium dependent? Eur J Echocardiogr 2:285–291PubMedCrossRefGoogle Scholar
  20. 20.
    Pugh ND, Hutcheson IR, Edwards DH, Nossen JO, Karlsson JO, Griffith TM (1995) Angiographic contrast media relax isolated rabbit aorta through an endothelium-independent mechanism that may not depend on the presence of the iodine atom. Br J Radiol 68:23–26PubMedCrossRefGoogle Scholar
  21. 21.
    Hutcheson IR, Griffith TM, Pitman MR, Towart R, Gregersen M, Refsum H et al (1999) Iodinate radiographic contrast media inhibit shear stress and agonist evoked release of NO by the endothelium. Br J Pharmacol 128:451–457PubMedCrossRefGoogle Scholar
  22. 22.
    Ishizaka H, Kuo L (1997) Endothelial ATP-sensitive potassium channels mediate coronary microvascular dilation to hyperosmolarity. Am J Physiol 273:H104–H112PubMedGoogle Scholar
  23. 23.
    Bagnis DG, Jacquiaud C, Dubois M, Adabra Y, Jaudon C (1999) Renal effects of low and isoosmolar contrast media on renal hemodynamic in a normal and ischemic dog kidney. Invest Radiol 34:1–4PubMedCrossRefGoogle Scholar
  24. 24.
    Liss P, Carlsson PO, Palm F, Hansell P (2003) Et-A receptor antagonist BQ123 prevents radiocontrast media-induced renal medullary hypoxia. Acta Radiol l44:111–117CrossRefGoogle Scholar
  25. 25.
    Hetzel GR, May P, Hollenbeck M, Voiculescu A, Modder U, Grabensee B (2001) Assessment of radiocontrast media induced renal vasoconstriction by color coded duplex sonography. Ren Fail 23:77–83PubMedCrossRefGoogle Scholar
  26. 26.
    Toda N, Okamura T (1992) Regulation by nitroxidergic nerve of arterial tone. Int Union Physiol Sci 7:148–156Google Scholar
  27. 27.
    Brian JE (1998) Carbon dioxide and the cerebral circulation. Anesthesiology 88:1365–1386PubMedCrossRefGoogle Scholar
  28. 28.
    Scheller B, Hennen B, Thunenkotter T, Mrowietz C, Markwirth T, Shieffer H et al (1999) Effect of X-Ray contrast media on blood flow properties after coronary angiography. Thromb Res 96:253–260PubMedCrossRefGoogle Scholar
  29. 29.
    Thomsen SH, Morcos SK (2004) Management of acute adverse reactions to contrast media. Eur Radiol 14:476–481PubMedCrossRefGoogle Scholar
  30. 30.
    Osterloh K, Gaehtgens P, Pries AR (2000) Determination of microvascular flow pattern formation in vivo. Am J Physiol Circ Physiol 278:H1142–H1152Google Scholar
  31. 31.
    Ben Ami R, Barshtein G, Zeltser D, Goldberg Y, Shapira I, Roth A et al (2001) Parameters of red blood cell aggregation as correlates of the inflammatory state. Am J Physiol Heart Circ Physiol 280:H1982–H1988PubMedGoogle Scholar
  32. 32.
    Davidson CJ, Laskey WK, Hermiller JB, Harrison JK, Matthai W, Vliestra RE et al (2000) Randomized trial of contrast media utilization in high-risk PTCA-The Court Trial. Circulation 101:2172–2177PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • C. Irace
    • 1
    Email author
  • S. Tamburini
    • 1
  • B. Bertucci
    • 1
  • M. S. De Franceschi
    • 1
  • A. Gnasso
    • 1
  1. 1.Dipartimento di Medicina Sperimentale e Clinica “G. Salvatore”Magna Græcia UniversityCatanzaroItaly

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