Intra-arterial iodinated radiographic contrast material injection administration in a rat middle cerebral artery occlusion and reperfusion model: possible effects on intracerebral hemorrhage.
Intra-arterial iodinated radiographic contrast material injection administration in a rat middle cerebral artery occlusion and reperfusion model: possible effects on intracerebral hemorrhage.
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DOI：
10.1161/strokeaha.110.578245
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发表时间：
2010-05
期刊：
影响因子：
8.3
通讯作者：
Tomsick TA
中科院分区：
文献类型：
--
作者：
Kurosawa Y;Lu A;Khatri P;Carrozzella JA;Clark JF;Khoury J;Tomsick TA
在人类介入性卒中治疗中的观察使我们假设碘化放射造影剂的使用可能导致脑出血。在一项安慰剂对照、设盲的大鼠临床前研究中，研究了动脉内碘化放射造影剂对大脑中动脉闭塞和再灌注后出血性转化的影响。雄性SD大鼠分为4组：生理盐水组（n=8）、对照组（n=12）、肝素组（n=9）和对照+肝素组（n=9）。使用缝线放置将大脑中动脉闭塞5小时。在拆线和再灌注前输注肝素。再灌注期间立即输注生理盐水和/或造影剂。通过24小时脑尸检检查确定出血的发生率、位置和大小。皮质出血的发生率从对照组（37.5%）、造影剂组（75.0%）、肝素组（77.8%）到造影剂+肝素组（100%; Cochran-Mantel-Haenszel相关性，P<0.01）显著增加。合并对照组（85.7%）和合并肝素组（88.9%）的脑皮质出血发生率均高于对照组（P<0.05）。在仅造影剂组（P=0.18）和仅肝素组（P=0.18）中观察到皮质脑内出血增加的相似趋势。与未接受造影剂的大鼠相比，接受造影剂的大鼠梗死水肿有减少的趋势（P=0.06）。与肝素相似，动脉内碘化造影剂可能增加脑皮质出血。碘化造影剂的作用可能是肝素对皮质脑内出血发生率的附加作用。
Observations in human interventional stroke treatment led us to hypothesize that iodinated radiographic contrast material use may contribute to intracerebral hemorrhage. Effects of intra-arterial iodinated radiographic contrast material on hemorrhagic transformation after middle cerebral artery occlusion and reperfusion were studied in a placebo-controlled, blinded preclinical study in rats. Four groups of male Sprague-Dawley rats were studied: saline group (n=8), contrast group (n=12), heparin group (n=9), and contrast+heparin group (n=9). The middle cerebral artery was occluded for 5 hours using suture placement. Heparin was infused before suture removal and reperfusion. Saline and/or contrast were infused immediately during reperfusion. Incidence, location, and size of hemorrhage were determined by brain necropsy inspection at 24 hours. There was a significant increase in incidence of cortical hemorrhage from control (37.5%), contrast (75.0%), heparin (77.8%) to contrast+heparin (100%; Cochran-Mantel-Haenszel correlation, P<0.01). Both pooled contrast groups (85.7%) and pooled heparin groups (88.9%) had higher rates of cortical intracerebral hemorrhage compared with the control group (P<0.05). Similar trends for increased cortical intracerebral hemorrhage were seen in the contrast-only (P=0.18) and heparin-only (P=0.18) groups. There was a trend for decreased infarct edema in rats receiving contrast versus those without (P=0.06). Intraarterial iodinated radiographic contrast material may increase cortical intracerebral hemorrhage, similar to heparin. Iodinated radiographic contrast material effect may be additive to heparin effect on the incidence of cortical intracerebral hemorrhage.