Comparison of Iodixanol 270 with Iohexol 300 in Infrapopliteal Arteriography

Purpose: To compare iodixanol 270 mg I ml with iohexol 300 mg I ml in infrapopliteal arteriography by measuring digital densitometric vessel opacification and by visually assessing angiographic enhancement. Material and Methods: In a double-blind, dual-balanced, 4-sequence crossover design, 50 claudicant patients received two contrast media injections (10 min interval) in the superficial femoral artery. Digital angiography was performed at 8 frames s and time-density curves with a circular region of interest over a distal calf artery were generated. A mixed, linear model was used to identify effects influencing the density measurements. Subjective evaluation of the image quality was made independently by two observers. Results: No statistically significant difference between the contrast media was revealed in the analysis of the densitometric measurements (p = 0.14) nor in the subjective visual evaluation (p = 0.74). However, the mean density at the time of maximum opacification was higher after the first injection than that after the second injection (p = 0.02). There was a tendency towards lower intensity of warmth during injection of iodixanol 270 than during injection of iohexol 300. Conclusion: In patients with severe occlusive atherosclerotic disease, iodixanol yielded the same image quality as iohexol in infrapopliteal arteriography, in spite of the 30 mg I ml lower iodine concentration.