Guo Ai-Bin, Yang Zhi-Qi, Zhao Bin, Li Yuan-Ming, Wei Ya-Xuan, Shao Shao-Ju, Zhang Guo-Zhen, Chen Hui-Sheng, Yin Rong
Department of Neurology, Gansu Provincial Central Hospital, Lanzhou, 730070, China.
Department of Neurology, the 940th Hospital of Joint Logistics Support force of Chinese People's Liberation Army, Lanzhou, China.
Sci Rep. 2025 Jul 24;15(1):26986. doi: 10.1038/s41598-025-12048-w.
The incidence of iodinated contrast media (ICM)-related adverse drug reactions (ADRs) varies significantly by procedure type. Compared other procedure types, cerebrovascular interventional procedures substantially increase the incidence of contrast-induced encephalopathy (0.38-2.90%). The associations of ioversol (nonionic low-osmolal ICM) with central nervous system (CNS) ADRs and iodixanol (nonionic ios-osmolal ICM) with cutaneous ADR manifestations have been establishe. This study aimed to compare the incidence of CNS ADRs and evaluate the occurrence, extent, and risk factors for ADRs associated with ioversol and iodixanol use during cerebrovascular interventional procedures. We conducted a prospective study involving 1,015 participants with suspected cerebrovascular diseases from July 2019 to July 2022. Participants underwent cerebrovascular interventional procedures with either iodixanol or ioversol administration. Data on ioversol and iodixanol-related CNS ADRs, data on other ADRs, and participants' baseline information were collected. Out of 848 participants (average age, 61.5 ± 12.6 years; 205 females) who received ICM, 16.7% (142 of 848) experienced CNS ADRs. Compared with iodixanol, ioversol was associated with a greater rate of CNS ADRs (12.6% vs. 21.1%, P = 0.001, RR = 1.666). Iodixanol was associated with higher rates of numbness and blurred vision (29.1% vs. 14.9%, P = 0.042), whereas ioversol was associated with higher incidences of headache and overall ADRs during the procedures (20.0% vs. 46.0%, P = 0.002). Logistic regression analysis revealed that a history of allergic diseases was a risk factor for iodixanol-related ADRs (odds ratio [OR], 2.5; 95% confidence interval [CI]: 1.2-4.9; P = 0.010). Severe cerebral vascular stenosis (OR, 2.8; 95% CI: 1.8-4.4; P < 0.001), female sex (OR, 0.5; 95% CI: 0.3-0.8; P = 0.005) and relatively young age (OR, 0.97; 95% CI: 0.95-0.99; P = 0.004) were risk factors for ioversol-related ADRs. Iodixanol appears to have a lower likelihood of causing ICM-related CNS ADRs than does ioversol during cerebrovascular interventional procedures.
含碘造影剂（ICM）相关不良药物反应（ADR）的发生率因手术类型而异。与其他手术类型相比，脑血管介入手术会大幅增加造影剂诱发脑病的发生率（0.38 - 2.90%）。已证实碘海醇（非离子低渗ICM）与中枢神经系统（CNS）ADR以及碘克沙醇（非离子等渗ICM）与皮肤ADR表现之间的关联。本研究旨在比较CNS ADR的发生率，并评估脑血管介入手术期间使用碘海醇和碘克沙醇相关ADR的发生情况、程度及危险因素。我们进行了一项前瞻性研究，纳入了2019年7月至2022年7月期间1015名疑似脑血管疾病患者。参与者接受了使用碘克沙醇或碘海醇的脑血管介入手术。收集了与碘海醇和碘克沙醇相关的CNS ADR数据、其他ADR数据以及参与者的基线信息。在848名接受ICM的参与者（平均年龄61.5±12.6岁；女性205名）中，16.7%（848名中的142名）出现了CNS ADR。与碘克沙醇相比，碘海醇与更高的CNS ADR发生率相关（12.6%对21.1%，P = 0.001，RR = 1.666）。碘克沙醇与更高的麻木和视力模糊发生率相关（29.1%对14.9%，P = 0.042），而碘海醇与手术期间更高的头痛和总体ADR发生率相关（20.0%对46.0%，P = 0.002）。逻辑回归分析显示，过敏疾病史是碘克沙醇相关ADR的一个危险因素（比值比[OR]，2.5；95%置信区间[CI]：1.2 - 4.9；P = 0.010）。严重脑血管狭窄（OR，2.8；95% CI：1.8 - 4.4；P < 0.001）、女性（OR，0.5；95% CI：0.3 - 0.8；P = 0.005）和相对年轻的年龄（OR，0.97；95% CI：0.95 - 0.99；P = 0.004）是碘海醇相关ADR的危险因素。在脑血管介入手术期间，碘克沙醇引起ICM相关CNS ADR的可能性似乎低于碘海醇。
