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| Publications [#197885] of Daniel B. Mark
Papers Published
- CJ Davidson, DB Mark, KS Pieper, KB Kisslo, MA Hlatky, DA Gabriel, TM Bashore, Thrombotic and cardiovascular complications related to nonionic contrast media during cardiac catheterization: analysis of 8,517 patients.,
The American journal of cardiology, vol. 65 no. 22
(June, 1990),
pp. 1481-4, ISSN 0002-9149
(last updated on 2011/11/29)
Abstract:
The incidence of major complications associated with nonionic contrast media has not been defined in a large study. Accordingly, cardiovascular complications, especially thrombotic events, were prospectively evaluated in 8,517 consecutive patients undergoing diagnostic cardiac catheterization with either iopamidol (n = 6,293) or iohexol (n = 2,224). Thrombotic events were defined as coronary embolus, coronary occlusion, transient ischemic attack or stroke occurring at the time of catheterization. Thrombotic events occurred in 15 patients (0.18%). Coronary thrombus or embolus occurred in 7 patients, a thromboembolus from the ventricular catheter occurred in 1 patients and transient ischemic attack or stroke occurred in 7 patients. Six of 15 patients with thrombotic events were premedicated with heparin. Thrombotic events were unusual in that they tended to occur in clusters within short time intervals. On 1 occasion, a thrombus was observed in the catheter tip before embolization. Other cardiovascular complications were similarly low with an incidence of ventricular tachycardia/fibrillation of 0.1%, profound bradycardia of 0.2% and prolonged angina of 0.3%. There were 2 deaths unrelated to thrombotic events. Although the clinical thrombotic events associated with nonionic contrast have an unusual temporal clustering and may result in major complications, the overall incidence (0.18%) of these thrombotic complications with nonionic contrast agents is quite similar to that reported with ionic contrast media.
Keywords:
Aged • Cardiovascular Diseases • Cerebrovascular Disorders • Embolism • Female • Heart Catheterization • Humans • Iohexol • Iopamidol • Male • Middle Aged • Prospective Studies • Thrombosis • adverse effects* • chemically induced • chemically induced* • etiology
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