The aim of the present study was to evaluate the effects of ionic (ioxaglate) and non-ionic (iopromide) contrast media on haemostatic parameters ex vivo. In 40 patients undergoing coronary angiography, platelet function (platelet reactivity and serotonin concentration) and coagulation markers [thrombin-antithrombin III complexes, prothrombin fragments (F1+2) and the D-dimers] were measured. The use of an ionic X-ray contrast agent (XCA) (ioxaglate) in diagnostic cardiac catheterisation angiography is associated with lower thrombin generation and lower activation of the platelet system than when a non-ionic XCA is employed (iopromide). The results thus confirm the results of various in vitro studies and animal investigations.

Aged↗

PubMedDate not supplied

Capillary occlusion and secondary angiogenesis in a patient with Raynaud's phenomenon.

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Adult↗

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Highly substituted hydroxyethyl starch (HES200/0.62) leads to Type-I von Willebrand syndrome after repeated administration.

Hydroxyethyl starch (HES) is a frequently used plasma substitute that is popular due to a high degree of therapeutic safety. However, the administration of large volumes of highly substituted, high-molecular-weight starch often leads to iatrogenic von Willebrand syndrome (vWS) with hemorrhagic complications. In patients with cerebral circulatory disturbances we carried out hemodilution therapy during 9-10 days, infusing HES 200/0.62. A von Willebrand factor (vWF) multimeric analysis was carried out in 6 patients using a modified western blot according to the sodium dodecyl sulfate agarose gel electrophoresis method. The vWF multimeric analysis showed that all multimers decreased to the same degree, corresponding to type-I vWS.

Aged↗

PubMedDate not supplied

[Torsion stability of coronary catheters].

In the present study, the torsional moments of 8 different types of catheter having two different calibres (n = 5 in each case) were investigated. The catheters were made of linear polyurethane (Cordis, Netherlands). The transmitted torsional moments of the 5.2 Fr. catheters positioned in a straight line were 1.48 +/- 0.09 Ncm (VK = 6%), positioned in a 90 degree curve 1.39 +/- 0.11 Ncm (VK = 8%). The corresponding figures for the 6 Fr. catheters were 2.43 +/- 0.20 Ncm (VK = 8%) and 2.26 +/- 0.20 Ncm (VK = 9%). The highly stable transmission behaviour in particular of the 5 Fr. catheters--with a variation coefficient of the torsional moments of 6%--is due mainly to the accurate manufacture of the catheters, and the material chosen. The study is a first step towards achieving systematic quality control of the materials used for diagnosis and therapy.

Cardiac Catheterization↗

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[The flow of contrast media in coronary catheters: study of the structural quality in interventional cardiology].

In the present study we investigated the contrast medium flow in 8 different types of left heart catheter having two different diameters (each n = 5). Using a 10 ml syringe and the contrast medium Ultravist 370, we calculated a mean value of 94.24 N + 16.01 for the maximum manual injection force in 18 test subjects. For the sake of simplicity, the figure of 100 N was defined as standardized manual force (which is within the standard deviation). If the maximally admissible static pressure of 82.5 bar is not to be exceeded, flow rates of not more than 16-17 ml/s are possible with 5.2 Fr. catheters, and 21-23 ml/s and 1.46 ml/s for 5.2 Fr. catheters, and between 1.99 ml/s and 2.17 ml/s for 6 Fr. catheters. Thus, a 50% higher flow can be achieved with 6 Fr. catheters as compared with 5.2 Fr. catheters at the same injection force. The iodine delivery rates are between 506 mg iodine/s and 539 mg iodine/s for 5.2 Fr. catheters, and between 738 mg iodine/s and 804 mg iodine/s for 6 Fr. catheters. The figures for the jet stream.

Cardiac Catheterization↗