Brunette Jean, Mongrain Rosaire, Rodés-Cabau Josep, Larose Eric, Leask Richard, Bertrand Olivier F
Department of Biomedical Engineering, Montreal Heart Institute, Montreal, Canada.
Catheter Cardiovasc Interv. 2008 Jan 1;71(1):78-83. doi: 10.1002/ccd.21400.
Several contrast media (CM) are used for diagnostic angiography and coronary percutaneous interventions. Catheter miniaturization allows performance of most diagnostic studies using 4-5 F catheters and interventions using 5-6 F catheters. As a result of catheter lumen downsizing and viscosity of CM, the operators are sometimes required to forcefully inject to produce adequate images.
The aim of the study is to perform a comparative rheology analysis between three different commonly used CM: iso-osmolar, nonionic iodixanol, Visipaque, (GE Healthcare); low-osmolar, nonionic ioversol, Optiray; and low-osmolar, ionic ioxaglate, Hexabrix, (Tyco Healthcare, US). The viscosity was experimentally assessed for temperature varying from 14 to 40 degrees C. To reproduce clinical use, an experimental set-up was used and the pressure developed to inject CM was evaluated at different temperatures and compared between the three CM. All three agents demonstrated a nonlinear inverse relationship between temperature and viscosity. At 14 degrees C iodixanol showed a twofold increase in viscosity compared with ioversol and ioxaglate. At 40 degrees C, the difference was reduced to 27%. At room temperature (20 degrees C), the difference in pressure needed to inject CM was 10% between iodixanol and ioxaglate and 6% between iodixanol and ioversol. As the temperatures increased, the differences in pressure became less important, becoming negligible (1%) at 37 degrees C.
The viscosity of the iso-osmolar nonionic contrast agent iodixanol showed a stronger dependence on temperature compared with ioversol and ioxaglate. The impact of differences in viscosity and pressure to inject between CM were minimized at 37 degrees C. This emphasizes the importance of temperature control when using current low-osmolar CM and iso-osmolar CM with smaller sized catheters.
几种造影剂（CM）用于诊断性血管造影和冠状动脉经皮介入治疗。导管小型化使得大多数诊断性研究可使用4-5F导管进行，介入治疗可使用5-6F导管进行。由于导管内腔尺寸减小以及造影剂的粘度，操作人员有时需要用力注射以获得足够的图像。
本研究的目的是对三种不同的常用造影剂进行比较流变学分析：等渗非离子型碘克沙醇（威视派克，通用电气医疗集团）；低渗非离子型碘佛醇（欧乃影，辉瑞制药）；以及低渗离子型碘克沙葡胺（泛影葡胺，泰科医疗，美国）。在14至40摄氏度的温度范围内对粘度进行了实验评估。为了重现临床应用，采用了一种实验装置，并在不同温度下评估了注射造影剂时产生的压力，并在三种造影剂之间进行了比较。所有三种制剂均显示温度与粘度之间呈非线性反比关系。在14摄氏度时，碘克沙醇的粘度比碘佛醇和碘克沙葡胺高出两倍。在40摄氏度时，差异降至27%。在室温（20摄氏度）下，注射造影剂所需压力在碘克沙醇与碘克沙葡胺之间相差10%，在碘克沙醇与碘佛醇之间相差6%。随着温度升高，压力差异变得不那么重要，在37摄氏度时可忽略不计（1%）。
与碘佛醇和碘克沙葡胺相比，等渗非离子型造影剂碘克沙醇的粘度对温度的依赖性更强。造影剂之间粘度和注射压力差异的影响在37摄氏度时降至最低。这强调了在使用当前低渗造影剂和等渗造影剂以及较小尺寸导管时控制温度的重要性。
