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KMID : 0350519930460010379
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Journal of Catholic Medical College
1993 Volume.46 No. 1 p.379 ~ p.390
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The Effects of Disturbed Circulation on Tissue Damage Induced by Subcutaneous Injection of Various Water Soluble Cfontrast Media in Rats
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Abstract
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Extravasation of intravenously injected contrast medium (CM) is a well known complication of radiologic procedures. Skin necrosis may occur as a result of extravasation, and has usually been reported following phlebography in the feet. The
puposes
of
this experimental study were to evaluate the cutaneous toxicity of commonly employed CM and to investigate the physicochemical characteristics of CM that influence tissue damage, especially under the circumstance of disturbed venous circulation.
One hundred rats, weighing 80-100g, were divided into nine groups acording to injected agents (iotrolan, ioxaglate, iopromide 300, iopromide 370, meglumine/sodium diatrizoate 76%, and NaCl solutions of various osmolality) and three subgroups
according
to the injection site and injection time after ligation. Left femoral and axillary veins were ligated proximally using silk Left feet were employed as ligated group and right feet as unligated group. Each ligated group was subdivided into two
groups
depending on the injection timc : CM was injected immediately after ligation in the acute group and 3 days after in the delayce group. 0.4 ml of CM was injected subcutaneously into the dorsum of left hind-foot and 0.3 ml of same osmolar NaCi
solution
into the dorsum of left forefoot. Right hind-feet and forefeet, serving as a unligated subgroup, received injection of same CM and NaCl solution using the same technique an volumes as with the left ligated subgroup. The tissue reaction of
injection
site
was grossly examined from 6 hours to 2 weeks after the injection. Representative gross changes were correlated with histologic findings.
@ES The results were as follows :
@EN 1. CM of higher osmolality caused more severe tissue damage than CM of lower osmolality in both unligated subgroup and ligated subgroup (P=0.05).
2. CM caused more severe tissue damage than NaCl solution of same osmolality in ligated acute group when the osmolality was 600 mosm/kg or more (P<0.05).
3. Low-osmolar ionic CM (ioxaglate0 showed considerably more toxic damage as compared with low-osmolar nonionic CM (iopromide 300) in ligated subgroup (P=0.05), but no significant difference of tissue damage in unligated subgroup.
4. Tissue damage was more severe in acute group than in delayed group (P<0.05).
By the results of this investigation, we recommend to use low-osmolar nonionic CM during the phlebography or during those procedures more likely to result in large extravasation in patents with compromised peripheral circulation.
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KEYWORD
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