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<meta name="DC.Title" content="Do Iodinated Contrast Agents Impair Fibrinolysis in Acute Stroke? A Systematic Review" />
<meta name="DC.Identifier" content="10.3174/ajnr.A1782" />
<meta name="DC.Date" content="2010-01-01" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: In vitro and nonhuman in vivo studies demonstrating impaired fibrinolysis of thrombus by thrombolytic agents in the presence of iodinated contrast media (ICM) have prompted concern regarding the clinical use of ICM. A systematic review and meta-analysis were performed to investigate the proportion of patients with acute stroke experiencing recanalization after thrombolytic therapy in whom ICM were administered compared with those in whom they were not.

MATERIALS AND METHODS: Embase and Medline searches identified studies reporting recanalization rates in acute ischemic anterior circulation stroke. Pooled proportions of patients who recanalized were calculated with a random-effects model, and studies involving contrast (CS) were compared with those without (NCS).

RESULTS: Six studies were found in which ICM were administered, and 12 studies, in which they were not. Studies were statistically heterogeneous. Combined pooled proportions and 95% confidence intervals (CI) for recanalization in unselected CS and NCS were 53% (36%–70%) and 61% (52%–71%), respectively. In a subgroup analysis in which only middle cerebral artery occlusions were considered, the pooled proportions in CS ( n = 3 studies) and NCS ( n = 9 studies) were 66% (95% CI, 49%–82%; I2, 0%) and 63% (CI, 52%–74%; I2, 82.5%).

CONCLUSIONS: Recanalization rates were not significantly different in patients who received iodinated contrast agents in clinical studies. A randomized trial to test whether ICM affect recanalization would require a prohibitively large number of subjects." />
<meta name="DC.Contributor" content="K.A. Dani" />
<meta name="DC.Contributor" content="K.W. Muir" />
<meta name="article:published_time" content="2010-01-01" />
<meta name="article:section" content="Interventional" />
<meta name="citation_title" content="Do Iodinated Contrast Agents Impair Fibrinolysis in Acute Stroke? A Systematic Review" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;In vitro and nonhuman in vivo studies demonstrating impaired fibrinolysis of thrombus by thrombolytic agents in the presence of iodinated contrast media (ICM) have prompted concern regarding the clinical use of ICM. A systematic review and meta-analysis were performed to investigate the proportion of patients with acute stroke experiencing recanalization after thrombolytic therapy in whom ICM were administered compared with those in whom they were not.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;Embase and Medline searches identified studies reporting recanalization rates in acute ischemic anterior circulation stroke. Pooled proportions of patients who recanalized were calculated with a random-effects model, and studies involving contrast (CS) were compared with those without (NCS).&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Six studies were found in which ICM were administered, and 12 studies, in which they were not. Studies were statistically heterogeneous. Combined pooled proportions and 95% confidence intervals (CI) for recanalization in unselected CS and NCS were 53% (36%–70%) and 61% (52%–71%), respectively. In a subgroup analysis in which only middle cerebral artery occlusions were considered, the pooled proportions in CS (&lt;i&gt;n&lt;/i&gt; = 3 studies) and NCS (&lt;i&gt;n&lt;/i&gt; = 9 studies) were 66% (95% CI, 49%–82%; I&lt;sup&gt;2&lt;/sup&gt;, 0%) and 63% (CI, 52%–74%; I&lt;sup&gt;2&lt;/sup&gt;, 82.5%).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Recanalization rates were not significantly different in patients who received iodinated contrast agents in clinical studies. A randomized trial to test whether ICM affect recanalization would require a prohibitively large number of subjects.&lt;/p&gt;" />
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<meta name="twitter:title" content="Do Iodinated Contrast Agents Impair Fibrinolysis in Acute Stroke? A Systematic Review" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: In vitro and nonhuman in vivo studies demonstrating impaired fibrinolysis of thrombus by thrombolytic agents in the presence of iodinated contrast media (ICM) have prompted concern regarding the clinical use of ICM. A systematic review and meta-analysis were performed to investigate the proportion of patients with acute stroke experiencing recanalization after thrombolytic therapy in whom ICM were administered compared with those in whom they were not.

MATERIALS AND METHODS: Embase and Medline searches identified studies reporting recanalization rates in acute ischemic anterior circulation stroke. Pooled proportions of patients who recanalized were calculated with a random-effects model, and studies involving contrast (CS) were compared with those without (NCS).

RESULTS: Six studies were found in which ICM were administered, and 12 studies, in which they were not. Studies were statistically heterogeneous. Combined pooled proportions and 95% confidence intervals (CI) for recanalization in unselected CS and NCS were 53% (36%–70%) and 61% (52%–71%), respectively. In a subgroup analysis in which only middle cerebral artery occlusions were considered, the pooled proportions in CS ( n = 3 studies) and NCS ( n = 9 studies) were 66% (95% CI, 49%–82%; I2, 0%) and 63% (CI, 52%–74%; I2, 82.5%).

CONCLUSIONS: Recanalization rates were not significantly different in patients who received iodinated contrast agents in clinical studies. A randomized trial to test whether ICM affect recanalization would require a prohibitively large number of subjects." />
<meta name="og-title" property="og:title" content="Do Iodinated Contrast Agents Impair Fibrinolysis in Acute Stroke? A Systematic Review" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/31/1/170" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: In vitro and nonhuman in vivo studies demonstrating impaired fibrinolysis of thrombus by thrombolytic agents in the presence of iodinated contrast media (ICM) have prompted concern regarding the clinical use of ICM. A systematic review and meta-analysis were performed to investigate the proportion of patients with acute stroke experiencing recanalization after thrombolytic therapy in whom ICM were administered compared with those in whom they were not.

MATERIALS AND METHODS: Embase and Medline searches identified studies reporting recanalization rates in acute ischemic anterior circulation stroke. Pooled proportions of patients who recanalized were calculated with a random-effects model, and studies involving contrast (CS) were compared with those without (NCS).

RESULTS: Six studies were found in which ICM were administered, and 12 studies, in which they were not. Studies were statistically heterogeneous. Combined pooled proportions and 95% confidence intervals (CI) for recanalization in unselected CS and NCS were 53% (36%–70%) and 61% (52%–71%), respectively. In a subgroup analysis in which only middle cerebral artery occlusions were considered, the pooled proportions in CS ( n = 3 studies) and NCS ( n = 9 studies) were 66% (95% CI, 49%–82%; I2, 0%) and 63% (CI, 52%–74%; I2, 82.5%).

CONCLUSIONS: Recanalization rates were not significantly different in patients who received iodinated contrast agents in clinical studies. A randomized trial to test whether ICM affect recanalization would require a prohibitively large number of subjects." />
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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div xmlns:xhtml="http://www.w3.org/1999/xhtml" class="contributors"><ol class="contributor-list" id="contrib-group-1"><li class="contributor" id="contrib-1"><span class="name">K.A. Dani</span><a id="xref-aff-1-1" class="xref-aff" href="#aff-1">a</a> and </li><li class="last" id="contrib-2"><span class="name">K.W. Muir</span><a id="xref-aff-1-2" class="xref-aff" href="#aff-1">a</a></li></ol><ol class="affiliation-list"><li class="aff"><a id="aff-1" name="aff-1"></a><address><sup>a</sup>From the Department of Neurology, Division of Clinical Neurosciences, University of Glasgow, Institute of Neurological Sciences, Glasgow, Scotland, UK.</address></li></ol><ol class="corresp-list"><li class="corresp" id="corresp-1">Please address correspondence to Keith W. Muir, MD, <span class="addr-line">Department of Neurology, Division of Clinical Neurosciences, University of Glasgow, Institute of Neurological Sciences, 1345 Govan Rd, Glasgow G51 4TF, Scotland, UK;</span> e-mail: <span class="em-link"><span class="em-addr">k.muir{at}clinmed.gla.ac.uk</span></span></li></ol></div></div><a href="http://ajnr-stage2.stage.highwire.org/content/31/1/170.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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