Cardiology Letters 2021, 30(3):185-191

Antiallergic premedication for hypersensitive patients before radiographic examinations with administration of intravascular contrast

Rašiová M¹, Koščo M¹, Petruš J², Mišíková S², Gibarti C³, Studenčan M²

¹ Klinika angiológie, LF UPJŠ, Východoslovenský ústav srdcových a cievnych chorôb, a. s., Košice

² Klinika kardiológie, LF UPJŠ, Východoslovenský ústav srdcových a cievnych chorôb, a. s., Košice

³ Oddelenia rádiológie, Východoslovenský ústav srdcových a cievnych chorôb, a. s., Košice, Slovenská republika

The routine use of angiographic and CT-angiographic examination requires rapid recognition and correct treatment of acute complications associated with contrast medium administration. A hypersensitivity reaction, which occurs less frequently with low- and isoosmolar contrast medium compared to hyperosmolar contrast medium administration, may have in the most severe cases fatal outcome. The greatest risk factor for hypersensitivity reaction is previous hypersensitivity reaction following contrast medium administration. Although it is a serious complication, there is no clear consensus among scientific societies regarding premedication of patient with history of contrast medium hypersensitivity reaction. Rare occurrence and lack of prospective randomized clinical trials confirming premedication benefit are the main reasons for different recommendations among scientific societies. We review recommendations from various international scientific societies, and at the same time we present our institutional protocol for management of patients undergoing radiographic examinations using contrast medium at the East Slovak Institute of Cardiovascular Diseases.

Keywords: contrast medium; premedication; allergy

Published: March 1, 2021  Show citation