Effects of ioxaglate and nonionic contrast media on erythrocytes filtrabillity and morphology. Review of previous studies and evaluation of clinical relevance

Abstract

Ioxaglate is an ionic low osmolar contrast medium (CM) widely used in radiological procedures, particularly for its effects on blood coagulation. In cases of cardiovascular and renal disease, where the microcirculatory system is of great importance, the hemorheologic properties of contrast media are emphasized.

In vitro studies (SEFAM erythrometer) to compare nonionic low osmolality CM and ioxaglate 50 % and 75 % vol/vol) have shown that ioxaglate decreases less the deformability of red blood cells. Further, morphological alterations (i.e. the formation of echinocytes and stomatocytes) occur more frequently with nonionic CM, whatever their osmolality, suggesting their chemotoxic effect. Preclinical experiments indicate that the hemorheologic properties of these media could be valuable clinically, limiting in particular CM nephrotoxicity in patients at risk (diabetes, pre-existing renal insufficiency etc.). The difficulties encountered in providing a clinical demonstration of these local effects explain why the possible consequences of these properties in cardiac and vascular disease have to date remained theoretical.