Iodinated contrast does not alter clotting dynamics in acute ischemic stroke as measured by thromboelastography.
BACKGROUND AND PURPOSE: Iodinated contrast agents used for computed tomography angiography (CTA) may alter fibrin fiber characteristics and decrease fibrinolysis by tissue plasminogen activator (tPA). Thromboelastography (TEG) measures the dynamics of coagulation and correlates with thrombolysis in acute ischemic stroke patients. We hypothesized that receiving CTA before tPA will not impair thrombolysis as measured by TEG.
METHODS: Acute ischemic stroke patients receiving 0.9 mg/kg tPA
RESULTS: Of 136 acute ischemic stroke patients who received tPA, 47 had CTA before tPA bolus, and 42 had either CTA after tPA and post-tPA TEG draw or no CTA (noncontrast group). Median change in clot lysis (LY30) after tPA was 95.3% in the contrast group versus 95.0% in the noncontrast group (P=0.74). Thus, tPA-induced thrombolysis did not differ between contrast and noncontrast groups. Additionally, there was no effect of contrast on any pre-tPA TEG value.
CONCLUSIONS: Our data do not support an effect of iodinated contrast agents on clot formation or tPA activity.
Published In/Presented At
McDonald, M. M., Archeval-Lao, J. M., Cai, C., Peng, H., Sangha, N., Parker, S. A., Wetzel, J., Riney, S. A., Cherches, M. F., Guthrie, G. J., Roper, T. C., Kawano-Castillo, J. F., Pandurengan, R., Rahbar, M. H., & Grotta, J. C. (2014). Iodinated contrast does not alter clotting dynamics in acute ischemic stroke as measured by thromboelastography. Stroke, 45(2), 462–466. https://doi.org/10.1161/STROKEAHA.113.003268
Medicine and Health Sciences
Department of Medicine