Influence of contrast media on thrombus formation during coronary angioplasty

• Published in: Journal of the American College of Cardiology Vol. 18; no. 2; pp. 443 - 450
• Main Authors: Gasperetti, Christine M., Feldman, Marc D., Burwell, Lawrence R., Angello, Debra A., Haugh, Kathryn H., Owen, Robert M., Powers, Eric R.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.08.1991; Elsevier Science
• Subjects: Angioplasty, Balloon, Coronary; Biological and medical sciences; Contrast Media - adverse effects; Coronary Angiography; Coronary Disease - therapy; Coronary Thrombosis - chemically induced; Coronary Thrombosis - epidemiology; Diatrizoate - adverse effects; Diatrizoate Meglumine - adverse effects; Drug Combinations; Female; Humans; Incidence; Investigative techniques, diagnostic techniques (general aspects); Iopamidol - adverse effects; Male; Medical sciences; Middle Aged; Multivariate Analysis; Osmolar Concentration; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Retrospective Studies; Human; Treatment; Pathophysiology; Thrombus; Instrumentation therapy; Cardiovascular disease; Complication; Coronary heart disease; Statistical study; Formation; Contrast media
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/0735-1097(91)90598-4

The influence of contrast media on thrombus formation during percutaneous transluminal coronary angioplasty was assessed in 124 consecutive patients undergoing coronary angioplasty and receiving either ionic (n = 57) (Group I) or nonionic (n = 67) (Group II) contrast medium. The presence of thrombus was assessed by qualitative analysis of angiograms in identical pre- and postangioplasty projections by four observers who had no knowledge of other data. Quantitation of stenosis severity before and after angioplasty and qualitative analysis of lesion eccentricity and complexity and of the presence of dissection were also performed. Although the baseline clinical characteristics of the two groups (including presenting syndromes and procedural and angiographic variables did not differ, more patients in Group II than Group I developed new thrombus during coronary angioplasty (18% vs. 4%, p < 0.02). In particular, patients with a presenting syndrome of recent myocardial infarction or rest angina, or both, and patients with an eccentric coronary plaque were more likely to develop new thrombus if they received nonionic than if they received ionic contrast medium (p < 0.05). Patients with new thrombus formation and patients with thrombus present both before and after angioplasty had a high incidence of acute procedural complications (36% and 23%, respectively). Patients in Groups I and II had a similar incidence of ischemic events during follow-up.