Overview

Visipaque: a contrast medium option when considering the special needs of more vulnerable patients.*

With more than 30 years of experience in providing diagnostic imaging solutions, GE Healthcare offers iodinated contrast media with a choice of osmolality that may help meet the individual needs of your patients.

Every patient case presents a unique clinical scenario. As with any procedure, it is important that the contrast media selection be based on each patient’s medical history, present condition, comorbidities and reasons for diagnostic assessment.

Proven to help manage risk in vulnerable patient populations

Approved for use in a broad range of intra-arterial and intravenous indications, Visipaque provides numerous benefits over low-osmolar contrast media (LOCM) agents in vulnerable patient populations,2-7 which include the following:*

  • Managing renal risk in patients vulnerable to contrast-induced acute kidney injury2,3
  • Minimising major adverse cardiac events (MACE)4,5
  • Managing pain or discomfort on injection, particularly in those patients undergoing peripheral angiography procedures6

Visipaque is formulated with balanced electrolytes

  • Visipaque is enriched with sodium and calcium in a physiologically favourable ratio to help minimise arrhythmias8,9,10

A range of concentrations and convenient sizes**

  • 270 mgI/mL and 320 mgI/mL7
  • 20, 50, 100, 200 and 500 mL7

**Concentrations, volumes and packaging vary from country to country

References:
1. Davidson C, Laskey W, Hermiller J et al. Am J Cardiol 2006; 98 (Suppl. 1): 42k-58k.
2. McCullough P. Cardiorenal Med 2011; 1: 220-34.
3. Dong M, Jiao Z, Liu T et al. J Nephrol 2012; 25(3): 290-301.
4. Davidson CJ, Laskey WK, Hermiller JB et al. Circulation 2000; 101: 2172-7.
5. Harrison JK. Am Heart J 2004; 147: 613-14.
6. Rosenberg C et al. J Invasive Cardiol. 2017; 29(1):9-15
7. Visipaque Summary of Product Characteristics UK, April 2015.
8. Almen T. Acta Radiol 1995; 36 (Suppl. 399): 2-18.
9. Fountaine H et al. Acad Radiol 1996; 3 (Suppl.3): S475-84.
10. Jynge P. Eur Radiol 1996; 6 (Suppl.2): S8-S12.

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Interventional

Interventional procedures are becoming more complex and involve increasingly older patients with a greater prevalence of co-morbidities.

With the same osmolality as blood, Visipaque induces less fluid shift from both red blood cells and endothelial cells than the low-osmolar contrast agents.2-5

Visipaque can help reduce kidney injury in high-risk patients2-7

  • Intra-arterial use of isosmolar Visipaque reduced the risk of contrast-induced acute kidney injury (CI-AKI) compared with LOCM in the interventional cardiology setting by 54% (RR=0.46; CI: 0.27-0.79; p=0.004)6
  • Visipaque improved outcomes in a further meta-analysis where its use reduced the risk of CI-AKI* compared with LOCM in the interventional cardiology setting by 32% (RR=0.68, 95% CI, 0.50-0.92)7
  • Visipaque has demonstrated renal benefits in a real-world setting8

Major adverse cardiac events (MACE) are also reduced with Visipaque9-11

  • Several large prospective clinical trials have shown that isosmolar Visipaque is associated with significantly fewer MACE (such as cardiac death, stroke and coronary artery bypass graft) than low-osmolar contrast media (LOCM)9-11

Furthermore, Visipaque can help reduce patient discomfort

  • Patient comfort may be of both clinical and practical importance. Sensation of heat or pain has the potential to lead to a series of events such as patient movement, poor image quality and repeat examinations leading to increased radiation and costs12,13
  • In a number of clinical studies spanning a range of procedures, isosmolar Visipaque has been shown to significantly reduce discomfort, heat and/or pain, compared to various ‘low’ osmolar CM12-18

*CI-AKI defined as SCr increase of ≥0.5 mg/dl from baseline measured up to 3 days after CM exposure.

References:
1. Davidson C, Laskey W, Hermiller J et al. Am J Cardiol 2006; 98 (Suppl. 1): 42k-58k.
2. Franke RP et al. Microvasc Res 2008; 76(2): 110-13.
3. Franke RP et al. Clin Hemorheol Microcirc 2011; 48 (1): 41-56.
4. Widmark JM. Proc (Bayl Univ Med Cent) 2007; 20(4): 408-17.
5. Barstad RM et al. Acta Radiol 1996; 37(6): 954-61.
6. McCullough P. Cardiorenal Med 2011; 1(4): 220-34.
7. Dong M et al. J Nephrol 2012; 25(3): 290-301.
8. Mallow PJ et al. Poster presented at EuroPCR May 2015, Paris, France.
9. Harrison J et al. Am Heart J 2004; 147: 612-4.
10. Davidson C et al. Circulation 2000; 101: 2172-7.
11. Nie B et al. Catheter Cardiovasc Interv 2008; 72: 958-65.
12. Verow P et al. Brit J Radiol 1995; 68: 973-8.
13. Manke C et al. Acta Radiologica 2003; 44: 590-6.
14. Tveit K et al. Acta Radiologica 1994; 35: 614-8.
15. Justesen P et al. Cardiovasc Intervent Radiol 1997; 20: 251-6.
16. Skehan SJ et al. Brit J Radiol 1998; 71: 910-17.
17. Maclennan-AC, Machan-LS. Cardiovasc Invervent Radiol 1997; 20 (Suppl. 1): Abs 167, 89.
18. Rosenberg C et al. J Invasive Cardiol 2017;29(1):9-15.

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CT in Oncology

The more you have to think about the diagnosis of your cancer patient, the less you want to worry about your contrast agent.

In cancer patients, Visipaque can help you achieve your desired outcomes2-7 by:

  • delivering diagnostic accuracy through enabling valuable contract-enhanced computed tomography (CT) in patients with renal impairment2
  • addressing renal complications considering vulnerable patients with multiple risk factors3,4,5
  • minimising contrast-associated pain protecting patient comfort and care6,7

Acute kidney injury is a significant burden in cancer3

  • While the etiology is often multifactorial, intravenous (IV) contrast media use is strongly associated with higher odds for acute kidney injury (AKI)3
  • Recent chemotherapy increases the risk of contrast-induced acute kidney injury (CI-AKI)8

Avoiding kidney injury can reduce both patient suffering and cost9,10

  • Contrast Media (CM) dose and osmolality are considered modifiable risk factors for CI-AKI9,11,12
  • Isosmolar Visipaque has been developed to provide care for kidneys4,5

The rate of CI-AKI in “high-risk” patients undergoing CT with iopromide was over 3 times that of Visipaque13

  • Diabetes was more prevalent in the Visipaque group (37.7% vs. 17.9%) (p=0.017)

  • The rate of CI-AKI with Visipaque in renally impaired cancer patients may not preclude them from having contrast -enhanced CT2

Managing pain with contrast media may be more relevant in cancer patients

  • Isosmolar Visipaque has been developed to minimise contrast-associated pain and heat sensation6,7 which may be severe in cancer patients7

References:
1. Davidson C, Laskey W, Hermiller J et al. Am J Cardiol 2006; 98 (Suppl. 1): 42k-58k.
2. Cheruvu B et al. J Comput Assist Tomogr 2007; 31: 493-8.
3. Salahudeen AL et al. Clin J Am Soc Nephrol 2013; 8: 347-54.
4. Jakobsen JA. Eur J Radiol 2007; 62 (Suppl.): S14-25.
5. Davidson C et al. Am J Cardiol 2006; 98 (Suppl.): 42k-58k.
6. Haussler MD. Acta Radiol 2010; 51: 924-33.
7. Weiland FL et al. Acta Radiol 2014; 55: 715-24.
8. Cicin I et al. Eur Radiol 2014; 24: 184-90.
9. Nyman U et al. Acta Radiol 2008; 49(6): 658-67.
10. De Francesco M et al. J Med Econ 2015 (Epub ahead of print).
11. Cho JY et al. J Cardiology 2010; 56(3): 300-6.
12. Windecker S et al. Eur Heart J 2014; 35: 2541-619. Accessed on: 1 April 2015.
13. Nguyen SA et al. Radiology 2008; 248: 97-105.

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CCTA

Putting diagnostic accuracy and patient care at the heart of Coronary Computed Tomography Angiography (cCTA).

With rapid advancements in technology, cCTA is fast emerging as a highly effective imaging technique.It is an accurate, cost-effective and patient friendly tool for diagnosing Coronary Artery Disease (CAD) in low-intermediate risk patients.2

Visipaque is designed for patient comfort3

  • The excellent comfort profile of Visipaque has been confirmed in over 9,500 patients undergoing a range of CT examinations in the outpatient setting4
  • The rate of severe discomfort in patients undergoing CT with iopamidol was over 6 times that of Visipaque5

Visipaque can help improve stent evaluability6

  • Visipaque 320 provided better image quality, allowing significantly higher evaluability of coronary stents than iomeprol 400 when injected at the same flow rate6
  • This was the result of a reduction of the beam hardening effect, which often leads to artefacts that may preclude accurate assessment of the coronary stent lumen6

Maintaining image quality with appropriate iodine loads

  • In multiple studies, Visipaque 320 has demonstrated similar or better diagnostic images than high-concentration contrast media (CM) which are hyperosmolar to blood, despite less iodine load6-11

Visipaque can help to minimise heat sensation and impact on heart rate6,7,12-14

  • Cardiac tolerability was better with Visipaque than iomeprol injected at the same flow rate6
  • Visipaque was associated with significantly less heat sensation than iomeprol6

References:
1. Davidson C, Laskey W, Hermiller J et al. Am J Cardiol 2006; 98 (Suppl. 1): 42k-58k.
2. Hassan A et al. Eur J Radiol 2011; 79(2): 161-71.
3. Almen T. Acta Radiol 1995; 36(Suppl.399): 2-18.
4. Haussler MD. Acta Radiol 2010; 51: 924-33.
5. Weiland FL et al. Acta Radiol 2014; 55: 715-24.
6. Andreini D et al. Cardiovasc Comput Tomogr 2014; B(1): 44-51.
7. Svensson A et al. Acta Radiologica 2010; 51(7): 722-6.
8. Becker CR et al. Invest Radiol 2011; 46(7): 457-64.
9. Ozbulbul N et al. Coronary Artery Dis 2010; 21(7): 414-9.
10. Maffei C et al. World J Radiol 2012; 4(6): 265-72.
11. Faggioni Let al. Am J Roentgenol 2012; 199(6): 1220-5.
12. Roche T et al. Arch Cardiovasc Imaging 2014; 2(3): e20708.
13. Loewe C et al. Insights Imaging 2014; 5 (Suppl.1): S304
14. Loewe C et al. Insights Imaging 2015; 6 (Suppl.1): S159.

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Prescribing Information


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