Non-ionic contrast agents, red cell aggregation and coagulation

Publisher Website
Google Scholar
Abstract
The second generation non-ionic contrast agents were introduced into clinical practice in the UK some 5 years ago. Since that time, and not withstanding their relatively high cost, they have enjoyed ever-increasing clinical application because of the many advantages they offer over previously available agents. These advantages include greater patient comfort (Dawson et al, 1983a; Dawson, 1985), greater patient safety in “high-dose” procedures (Dawson & Pitfield, 1982; Dawson & Hemingway, 1987) and, the evidence would suggest, a lower incidence of major, adverse, life-threatening idiosyncratic reactions (Schrott et al, 1986; McClennan, 1987). There has, of course, been controversy surrounding the cost of the non-ionic contrast agents but, this apart, there has been little to detract from their success story until recently. In the last year, two papers have appeared, one in the European (Raininko & Ylinen, 1987) and one in the American literature (Robertson, 1987), both concerned with the haematological effects of non-ionic contrast agents, which have raised fundamental questions about their safety in angiography. The paper by Raininko and Ylinen (1987) drew attention to the irregular aggregates of red cells formed when human blood is in contract with high concentrations of non-ionic agent. These irregular aggregates are similar to those seen when red cells are exposed to 5% glucose solutions (Ryden & Oberman, 1975; Wilson, 1980).