Piessens J H, Stammen F, Vrolix M C, Glazier J J, Benit E, De Geest H, Willems J L
Department of Cardiology, University Hospital Gasthuisberg, Leuven, Belgium.
Cathet Cardiovasc Diagn. 1993 Feb;28(2):99-105. doi: 10.1002/ccd.1810280203.
An increasing body of evidence suggests that the potential for thrombotic complications is greater with nonionic than with ionic contrast agents. This is a particularly important consideration in the highly thrombogenic setting of percutaneous transluminal coronary angioplasty (PTCA). To explore this issue further, 500 consecutive patients undergoing PTCA were prospectively randomized to receive the low osmolality ionic ioxaglate or the nonionic agent iohexol. The number of acute thrombotic in-laboratory events was significantly less in the ioxaglate than in the iohexol group (8 versus 18; P < 0.05), but there was no significant difference between the 2 groups as regards the number of out-of-laboratory acute rethrombotic events. With multivariate analysis, use of the nonionic agent rather than the ionic agent emerged as an independent predictor of acute in-laboratory rethrombosis. These data suggest that, in the performance of PTCA, an ionic, rather than a nonionic, should be the preferred contrast agent.
越来越多的证据表明，与离子型造影剂相比，非离子型造影剂发生血栓并发症的可能性更大。在经皮腔内冠状动脉成形术（PTCA）这种高血栓形成倾向的情况下，这是一个特别重要的考虑因素。为了进一步探讨这个问题，对500例连续接受PTCA的患者进行前瞻性随机分组，分别给予低渗离子型碘克沙醇或非离子型造影剂碘海醇。碘克沙醇组实验室急性血栓形成事件的数量明显少于碘海醇组（8例对18例；P<0.05），但两组在实验室外急性再血栓形成事件的数量方面没有显著差异。通过多变量分析，使用非离子型造影剂而非离子型造影剂是实验室急性再血栓形成的独立预测因素。这些数据表明，在进行PTCA时，离子型而非非离子型造影剂应作为首选造影剂。
