Elimination of the Diatrizoate–Induced Effects on the Microcirculation by the Prostacyclin Derivative, Iloprost

Krausc W, Klopp R, Niemer W, Schippel W, Kulmann H. Elimination of the diatrizoate-induced effects on the microcirculation by the prostacyclin derivative, iloprost. RATIONALE AND OBJECTIVES.Contrast media, especially high-osmolar ionic compounds elicit drastic effects on the microcirculation. In some areas of the microcirculatory network, blood flow decreases up to total stasis; in other areas, blood velocity increases. The authors studied the effect of the stable prostacyclin derivative, iloprost, added to the diatrizoate formulation on the number of perfused microvessels in the rat intestine. METHODS.Diatrizoate (600 mg iodine/kg) and increasing concentrations of iloprost, ranging from a total dose of 0 to 560 ng/kg, were injected intravenously into groups of four anesthetized male rats. The number of unperfused microvessels in the intestine were determined by in vivo microscopy. Each animal received two treatments at an interval of 35 minutes. One treatment consisted of diatrizoate alone, the other treatment consisted of diatrizoate plus iloprost. Two animals of each group received first diatrizoate alone and then diatrizoate plus iloprost. The other two animals first received diatrizoate plus iloprost and then diatrizoate alone. RESULTS.Diatrizoate alone reduced the number of perfused microvessels by 45%. The addition of iloprost resulted in a dose-dependent improvement of microcirculation. At a dose of 280 ng/kg, the effects of diatrizoate were completely abolished. Increasing the dose further diminished this effect. CONCLUSIONS.The addition of iloprost to diatrizoate eliminates the deleterious effects of diatrizoate on microcirculation.