Stability of contrast media induced red cell aggregates. A review

Abstract

When nonionic contrast media come into contact with blood, large red cell aggregates are formed. These aggregates, visible to the naked eye, have caused confusion among radiologists and prompted fear of embolism. Studies on the stability of the aggregates are reviewed. Large, irregular aggregates induced by nonionic contrast media are more stable than rouleaux and even more stable than irregular aggregates induced by glucose. However, they disperse under slight mechanical stress and in an ionic environment. Shear forces during injection and contact with an ionic flush solution and plasma prevent embolic complications during angiography.