Matching articles for "angiography"
In Brief: Toxicity of Gadolinium-Based Contrast Agents
The Medical Letter on Drugs and Therapeutics • June 4, 2007; (Issue 1262)
Gadolinium-based contrast agents, which are used mainly for magnetic resonance imaging and angiography, were first introduced partly because of the discovery in the 1990’s that iodine-based contrast agents...
Gadolinium-based contrast agents, which are used mainly for magnetic resonance imaging and angiography, were first introduced partly because of the discovery in the 1990’s that iodine-based contrast agents could cause nephrotoxicity and acute renal failure. Some recent reports have suggested, however, that gadolinium-based agents may also be nephrotoxic.1 One patient who developed acute renal failure after use of gadolinium-based contrast had a renal biopsy that showed acute tubular injury.2
Moreover, after exposure to gadolinium-based contrast, some patients with severe renal insufficiency, or liver disease with any degree of renal insufficiency, have developed nephrogenic systemic fibrosis, with sclerodermalike changes in the skin, connective tissues and other organs, which has sometimes been fatal.3,4 The mechanism is unknown; release of free gadolinium ions, which are toxic, has been suggested.5
Gadolinium-containing contrast agents are marketed in the US as Magnevist, MultiHance, Omniscan, OptiMARK, and ProHance (www.fda.gov). In patients with renal insufficiency, especially those requiring dialysis, use of any contrast agent should be avoided if possible.
1. C Briguori et al. Gadolinium-based contrast agents and nephrotoxicity in patients undergoing coronary artery procedures. Cath Cardiovasc Interven 2006; 67:175.
2. H Akgun et al. Are gadolinium-based contrast media nephrotoxic? A renal biopsy study. Arch Pathol Lab Med 2006; 130:1354.
3. AS Boyd et al. Gadolinium deposition in nephrogenic fibrosing dermopathy. J Am Acad Dermatol 2007; 56:27.
4. A Deo et al. Nephrogenic systemic fibrosis: a population study examining the relationship of disease development to gadolinium exposure. Clin J Am Soc Nephrol 2007; 2:264.
5. T Grobner and FC Prischl. Gadolinium and nephrogenic systemic fibrosis. Kidney Int 2007 May 16; epub ahead of print.
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Moreover, after exposure to gadolinium-based contrast, some patients with severe renal insufficiency, or liver disease with any degree of renal insufficiency, have developed nephrogenic systemic fibrosis, with sclerodermalike changes in the skin, connective tissues and other organs, which has sometimes been fatal.3,4 The mechanism is unknown; release of free gadolinium ions, which are toxic, has been suggested.5
Gadolinium-containing contrast agents are marketed in the US as Magnevist, MultiHance, Omniscan, OptiMARK, and ProHance (www.fda.gov). In patients with renal insufficiency, especially those requiring dialysis, use of any contrast agent should be avoided if possible.
1. C Briguori et al. Gadolinium-based contrast agents and nephrotoxicity in patients undergoing coronary artery procedures. Cath Cardiovasc Interven 2006; 67:175.
2. H Akgun et al. Are gadolinium-based contrast media nephrotoxic? A renal biopsy study. Arch Pathol Lab Med 2006; 130:1354.
3. AS Boyd et al. Gadolinium deposition in nephrogenic fibrosing dermopathy. J Am Acad Dermatol 2007; 56:27.
4. A Deo et al. Nephrogenic systemic fibrosis: a population study examining the relationship of disease development to gadolinium exposure. Clin J Am Soc Nephrol 2007; 2:264.
5. T Grobner and FC Prischl. Gadolinium and nephrogenic systemic fibrosis. Kidney Int 2007 May 16; epub ahead of print.
Download U.S. English
Clopidogrel (Plavix) Revisited
The Medical Letter on Drugs and Therapeutics • April 10, 2006; (Issue 1232)
Clopidogrel (Plavix - Sanofi-Aventis and Bristol-Myers Squibb), an oral thienopyridine that inhibits platelet aggregation, is now being advertised directly to the public on television. Clopidogrel is approved...
Clopidogrel (Plavix - Sanofi-Aventis and Bristol-Myers Squibb), an oral thienopyridine that inhibits platelet aggregation, is now being advertised directly to the public on television. Clopidogrel is approved by the FDA for secondary prevention of myocardial infarction (MI), stroke and other vascular events and for use in patients with acute coronary syndrome (unstable angina or non-ST-elevation MI), including those undergoing angioplasty. It is used off-label for patients with ST-elevation acute MI