Safety of Nonionic Agents in Visceral Angiography

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RATIONALE AND OBJECTIVES. To compare the safety of ionic and nonionic contrast agents in visceral angiography.

METHODS. Beginning in 1989, a prospective, open trial was begun, and 1,890 patients who have undergone contrast injection were enrolled. Patients considered to be high risk were graded according to Palmer and received nonionic contrast media, while all other patients received ionic contrast media.

RESULTS. Because of the small number of visceral angiography procedures performed (38), no definitive conclusions could be drawn as to the differences between ionic and nonionic agents regarding grade-2 and grade-3 adverse events. However, a difference in grade-1 events was apparent in favor of nonionic agents.

CONCLUSIONS. More than 10 years ago, the Department of Radiology staff at Aker Hospital began using iohexol, first in infants, then in children, pregnant women, patients undergoing leg phlebography, and patients with serious, previously documented reactions from contrast media. Currently, the department staff administers nonionic agents exclusively for coronary angiography and other cardiac procedures in approximately 300 patients per year. Today, use of nonionic contrast media is the standard for almost all procedures requiring intra-arterial or intravenous application.

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