Taking the Iso- or Low-osmolar Road in Angio Contrast

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Chris Kaiser, Editor

The debate regarding the safest type of angiography contrast media got revived last month. A meta-analysis found no difference between the only FDA-approved iso-osmolar agent (Visipaque from GE Healthcare) and several low-osmolar agents. Current guidelines recommend the use of iso-osmolar agents and the researchers suggested that the guidelines be changed based on their analysis.

Bracco Diagnostics quickly issued a release touting its low-osmolar agent, IsoVue, which fared well, especially among the other low-osmolar agents. Once facilities look at this new safety profile, the next factor is cost and low-osmolar agents are traditionally less expensive then the iso-osmolar agents.

Another interesting study looked at the speed of information flow and how that affects practice patterns. One telling incident was when negative data about late stent thrombosis was reported at a conference in 2006. By March of 2007, there was a significant drop in drug-eluting stent (DES) usage. The researchers said that the results traveled rapidly via email, search engines and smartphones.

They acknowledge that this type of information dissemination is part of the modern age, but they cautioned that it must be managed effectively, particularly regarding data that is not peer reviewed.

Other research of note revealed that the supply of cardiothoracic surgeons is dwindling, whilst a growth in angiography procedures has been forecasted. These two studies seem complementary, however unfortunate for cardiothoracic surgeons.

Paralleling the decrease in surgeons is a dwindling supply of cardiologists, although not to the same extreme. Interestingly, the angio suite is increasingly being used by interventional radiologists and vascular surgeons. Vendors of angio equipment should be giddy with delight no matter who is performing what. So while the participants in the angio suite jockey for position, manufacturers should get ready to replace aging equipment and to modernize labs so they accommodate the ever-expanding base of interventionalists and procedures.

I also encourage you to check out two articles from the latest edition of Cardiovascular Business: This one about next-generation drug-eluting stents and this update on the latest guidewire technology.

To access more resources pertaining to coronary interventions, please go to our Healthcare TechGuide, which contains lists of vendors, whitepapers and a calendar of events.

As always, I welcome your comments on these or any other topics.

Chris P. Kaiser, Editor
Cardiovascular Business