Rate of major adverse renal or cardiac events with iohexol compared to other low osmolar contrast media during interventional cardiovascular procedures

Q4 · MEDICINE

Article

Author: Todoran, Thomas M. ; Ryan, Michael P. ; McCullough, Peter A. ; Gunnarsson, Candace ; Brilakis, Emmanouil S.

AbstractObjectiveThis study assessed the rate of major adverse renal or cardiac events (MARCE) when iohexol is used during interventional cardiovascular procedures compared to other low osmolar contrast media (LOCMs).BackgroundInterventional cardiovascular procedures are often essential for diagnosis and treatment, the risk of MARCE should be considered.MethodsData were derived from the Premier Hospital Database January 1, 2010 through September 30, 2015. Patient encounters with an inpatient primary interventional cardiovascular procedure with a single LOCM (iohexol, ioversol, ioxilan, ioxaglate, or iopamidol) were included. The primary outcome was a composite endpoint of MARCE, which included: renal failure with dialysis, acute kidney injury (AKI) with or without dialysis, contrast induced AKI, acute myocardial infarction, angina, stent occlusion/thrombosis, stroke, transient ischemic attack, or death. Multivariable regression analysis was performed using the hospital fixed‐effects specification to assess the relationship between MARCE and iohexol compared to other LOCMs, while controlling for patient demographics, comorbid conditions and reason for hospitalization. As a sensitivity analysis, direct comparisons of iohexol were made to other LOCMs.ResultsA total of 458,091 inpatient encounters met inclusion criteria of which 26% used iohexol and 74% used other LOCMs. Results of multivariable modeling revealed no differences in MARCE rates between iohexol and other LOCMs. When direct comparisons of iohexol vs. ioversol and iopamidol were modeled, no differences in MARCE nor the renal component of MARCE were found.ConclusionsIn this retrospective multicenter study, there were no differences in MARCE events with iohexol compared to other LOCMs during inpatient interventional cardiovascular procedures.

01 Jan 2018·Interventional Neurology

Usefulness of Cone Beam Intra-Arterial CTA for Evaluation of Flow Diverters: A Practical Approach for Daily Use

Article

Author: Alcala, Indiana ; Reyes, Dennys ; Becerra, Victor ; Dabus, Guilherme ; Linfante, Italo

Cone beam computed tomography (CBCT), initially used for evaluation of intraprocedural complications such as hemorrhage, has evolved to provide details of implanted devices such as flow diverters. The study aim is to present our experience in using CBCT with intra-arterial injection and provide a step-by-step approach for postprocessing in a practical protocol for daily use. IRB approval was obtained, and the neurointerventional database was retrospectively reviewed from July 2012 to June 2017. Patients who underwent cone beam intra-arterial CT angiography for evaluation of implanted flow diverter devices were reviewed. Patient demographics, aneurysm location (internal carotid artery [ICA]-cavernous, ICA-paraclinoid, and ICA-distal; middle cerebral artery [MCA], anterior cerebral artery [ACA]-acom, ACA-pericallosal, vertebral artery [VA]), type (saccular, dissecting fusiform, or blister) and size, device, injection technique (contrast dilution, rate, and volume), and reconstruction protocol were recorded. Acquired images were postprocessed using a Philips Xtravision workstation. Eighty patients (63 women and 17 men) met the inclusion criteria of our study. Age range was 25–80 years old. Treated aneurysms were located in the ICA-paraclinoid in 48 cases (60%), ICA-distal in 12 cases, ICA-cavernous in 8 cases, MCA in 4 cases, VA in 4 cases, ACA-acom in 2 cases, ACA-pericallosal in 2 cases; 69 were saccular, 8 fusiform, and 3 ruptured blister aneurysms. There were 52 small, 20 large, and 8 giant aneurysms. Pipeline (Medtronic, MN, USA) was the predominant device used in 77 procedures. Two injection techniques were used: 2.5 mL/s for a total volume of 55 mL with a 2-s imaging delay or 3 mL/s for a total volume of 70 mL with a 3-s imaging delay; contrast (Ioxilan 300 mgI/mL) dilution was 10–20% in all cases. The device’s landing zones, conformability, presence of deformities, and wall apposition were successfully visualized in all cases. Metal artifact reduction program was applied in 9 coiled aneurysms, and this was satisfactory as well.

01 Feb 2014·NeuropharmacologyQ2 · MEDICINE

Effects of the hallucinogen 2,5-dimethoxy-4-iodophenethylamine (2C-I) and superpotent N-benzyl derivatives on the head twitch response

Q2 · MEDICINE

Article

Author: Halberstadt, Adam L ; Geyer, Mark A

N-benzyl substitution markedly enhances the affinity of phenethylamine hallucinogens at the 5-HT(2A) receptor. N-benzyl substituted derivatives of 2,5-dimethoxy-4-iodophenethylamine (2C-I), such as N-(2-methoxybenzyl)-2,5-dimethoxy-4-iodophenethylamine (25I-NBOMe) and N-(2,3-methylenedioxybenzyl)-2,5-dimethoxy-4-iodophenethylamine (25I-NBMD), have appeared recently as designer drugs, but have not been characterized behaviorally. The head twitch response (HTR) is induced by 5-HT(2A) receptor activation in rats and mice, and is widely used as a behavioral proxy for hallucinogen effects in humans. Nevertheless, it is not clear whether phenethylamine hallucinogens reliably provoke this behavior. Hence, we investigated whether 2C-I, 25I-NBOMe and 25I-NBMD induce head twitches in C57BL/6J mice. The HTR was assessed using a head-mounted magnet and a magnetometer coil. 2C-I (1-10 mg/kg SC), 25I-NBOMe (0.1-1 mg/kg SC), and 25I-NBMD (1-10 mg/kg SC) induced the HTR. 25I-NBOMe displayed 14-fold higher potency than 2C-I, and the selective 5-HT(2A) antagonist M100,907 completely blocked the HTR induced by all three compounds. These findings show that phenethylamine hallucinogens induce the HTR by activating 5-HT(2A) receptors. Our results demonstrate that 25I-NBOMe is a highly potent derivative of 2C-I, confirming previous in vitro findings that N-benzyl substitution increases 5-HT(2A) affinity. Given the high potency and ease of synthesis of N-benzylphenethylamines, it is likely that the recreational use of these hallucinogens will become more widespread in the future.

100 Deals associated with Ioxilan

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D02161	Ioxilan	V08AB12	DB09135

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Indication	Country/Location	Organization	Date
Vascular Diseases	US	-	22 May 1997

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