[Contrast material with oxygenated Fluosol-DA, 20 for the protection against complications of catheter cerebral angiography].

Although computed tomography may change the criteria of cerebral angiography in neurosurgery, the neurosurgeon still requires angiographic confirmation of vascular anatomy at the operative sites, and catheterization for intra-luminal constructive surgery is also seeing progress. Cerebral angiography is a rather safe procedure; however, persistent serious neurological deficits and fatal complications are occasionally reported. The mechanisms of these complications are considered to be due to mechanically dislodged fragments of clots and/or atheroma, or direct endothelial damage by the catheter, contrast agents toxicity to brain tissue, anoxic neurocytologic injury due to the disturbance of the blood flow. Fluosol-DA (a type of perfluorochemical) has a potent oxygen-carrying capacity and has been safely used in humans as an artificial blood substitute. Meglumine diatrizoate (65% Angiografin) has not lost the x-ray opacification faculty in cerebral angiography by mixing with oxygenated Fluosol-DA, 20 up to 30 vol % of the latter in clinical use. In animal experiments, from 0.25 to 4 ml/kg of Angiografin-65 or Angiografin-65 with oxygenated Fluosol-DA, 20 were injected into the internal carotid artery of mongrel dogs. When 2.0 ml/kg of Angiografin-65 was injected into the carotid artery, remarkable arrhythmia was observed for 7.5 seconds. Blood pressure dropped 28.3 mmHg for 20.2 seconds; thereafter, it increased 25 mmHg in rebound for 15 seconds. Intracranial pressure increased 5 mmHg for 35 seconds, respiratory disturbance continued for 22.6 seconds. When a 20 vol % mixture of Fluosol-DA, 20 with Angiografin-65 was applied, these adverse reactions were markedly reduced.(ABSTRACT TRUNCATED AT 250 WORDS)