Evaluation of iopamidol and diatrizoate in excretory urography: a double-blind clinical study.
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In a prospective double blind randomised study in 25 consecutive patients a conventional ionic contrast medium (Urografin 370) was compared with the new non-ionic medium iohexol 350 ( Omnipaque ) in left ventriculography and coronary arteriography. In left ventriculography there was a clear patient preference for iohexol by both a visual analogue scale and independent observer assessment. Iohexol also induced a smaller increase in heart rate or decrease in systolic blood pressure than Urografin. In coronary arteriography iohexol resulted in a smaller reduction in heart rate and systolic blood pressure, a smaller maximum increase in RR interval, less prolongation of the PQ and QT intervals and QRS duration, and a lower incidence of induced chest pain, ST segment depression, or T wave deflection.
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The toxicity of Renografin 76% was compared with that of Hypaque 76% by selective injection of each into the right coronary artery of dogs. Renografin contains the chelating agents sodium citrate and disodium edetate, while Hypaque contains calcium disodium edetate and no sodium citrate. Ventricular fibrillation occurred significantly more often with Renografin, suggesting that chelating agents contribute to toxicity in coronary angiography.
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