Nishino M, Tanouchi J, Kawabata M, Tanaka K, Ito T, Kato J, Yamada Y, Kamada T
Division of Cardiology, Osaka Rosai Hospital, Sakai-City, Japan.
Catheter Cardiovasc Interv. 1999 May;47(1):6-13. doi: 10.1002/(SICI)1522-726X(199905)47:1<6::AID-CCD2>3.0.CO;2-L.
We evaluated the potential for improving visualization at intervention sites using contrast-enhanced intracoronary ultrasound (ICUS) and the suitable contrast agents for this procedure in humans. In 37 patients, ICUS (30 MHz) was performed with intracoronary bolus injection (3 mL) of seven different contrast preparations and without the contrast agents (control) after coronary intervention. The contrast agents used were as follows: saline solution, standard iomeprol, standard ioxaglate, sonicated iomeprol, sonicated ioxaglate, 50% Albunex, and 100% Albunex. Homogeneous and complete opacification of the vessel lumen and false lumen was observed with sonicated ioxaglate, 50% and 100% Albunex. Shadowing was not observed at all with sonicated ioxaglate and was uncommon with 50% Albunex, whereas 100% Albunex caused shadowing in all cases. The coronary delineation rate with the other contrast agents was only 60%-70%, and the homogeneity and peak intensity were relatively low. Thus, sonicated ioxaglate and 50% Albunex both achieved good visualization, but the latter is more expensive, more difficult to handle, and takes longer to prepare. Of the agents we studied, sonicated ioxaglate appears to be best suited for contrast-enhanced ICUS. ICUS using suitable contrast agents could only visualize the large dissections and the strategy was changed according to the contrast-enhanced ICUS results in five cases. Thus, suitable contrast agents, e.g., sonicated ioxaglate, should be used during ICUS after intracoronary intervention.
我们评估了使用对比增强型冠状动脉内超声（ICUS）改善干预部位可视化的潜力，以及适用于该操作的人体对比剂。在37例患者中，冠状动脉介入术后，通过冠状动脉内推注（3 mL）七种不同的对比剂制剂并在不使用对比剂（对照）的情况下进行ICUS（30 MHz）检查。所用对比剂如下：生理盐水、标准碘海醇、标准碘克沙醇、超声处理的碘海醇、超声处理的碘克沙醇、50%白蛋白微球和100%白蛋白微球。超声处理的碘克沙醇、50%和100%白蛋白微球可观察到血管腔和假腔的均匀且完全显影。超声处理的碘克沙醇完全未观察到声影，50%白蛋白微球少见声影，而100%白蛋白微球在所有病例中均引起声影。其他对比剂的冠状动脉显影率仅为60%-70%，均匀性和峰值强度相对较低。因此，超声处理的碘克沙醇和50%白蛋白微球均实现了良好的可视化，但后者更昂贵、更难操作且制备时间更长。在我们研究的对比剂中，超声处理的碘克沙醇似乎最适合对比增强型ICUS。使用合适对比剂的ICUS仅能显示大的夹层，5例患者根据对比增强型ICUS结果改变了治疗策略。因此，冠状动脉介入术后进行ICUS时应使用合适的对比剂，如超声处理的碘克沙醇。
