| Reference | 1. Echocardiography. 2015 Aug;32(8):1329. doi: 10.1111/echo.12971.<br />
Perflutren-Induced Angioedema.<br />
Gupta A(1), Harris S(1), Naina H(1).<br />
DOI: 10.1111/echo.12971 PMID: 26192312<br />
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2. JACC Cardiovasc Imaging. 2014 Feb;7(2):206-7. doi: 10.1016/j.jcmg.2013.11.003.<br />
Perflutren-based echocardiographic contrast in patients with right-to-left intracardiac shunts.<br />
Kalra A, Shroff GR, Erlien D, Gilbertson DT, Herzog CA.<br />
DOI: 10.1016/j.jcmg.2013.11.003 PMID: 24524748<br />
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3. Drug Saf. 2015 Nov;38(11):1127-39. doi: 10.1007/s40264-015-0332-6.<br />
Safety of Perflutren Ultrasound Contrast Agents: A Disproportionality Analysis of the US FAERS Database.<br />
Hauben M(1)(2), Hung EY(3), Hanretta KC(4), Bangalore S(1), Snow V(2).<br />
INTRODUCTION: Perflutren microbubble/microsphere ultrasound contrast agents have a black-box warning based on case reports of serious cardiopulmonary events. There have been several subsequent observational safety studies. Large spontaneous reporting databases may help detect/refine signals of rare adverse events that elude other data sources/study designs. OBJECTIVE: The objective of this study was to supplement existing knowledge of the reported safety of perflutren using statistical analysis of spontaneous reports.<br />
DOI: 10.1007/s40264-015-0332-6 PMID: 26242615<br />
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4. Circ J. 2003 Jul;67(7):630-6. doi: 10.1253/circj.67.630.<br />
Influence of contrast ultrasonography with perflutren lipid microspheres on microvessel injury.<br />
Kobayashi N(1), Yasu T, Yamada S, Kudo N, Kuroki M, Miyatake K, Kawakami M, Saito M.<br />
Microbubbles have been reported to enhance ultrasound (US)-related side effects in animal systems. The present study investigated the influence of contrast ultrasonography (US) with perflutren lipid microspheres, a recently developed second-generation contrast agent, on microvessels. Rat mesentery was exposed to 1.8-MHz pulsed US with intravenous injection of perflutren (0.1 or 1.0 ml/kg) or Levovist (300 mg/kg), and the microvessel bleeding and endothelial cell injury was examined. Impaired endothelial cells were identified by the fluorescence of propidium iodide. Microvessel bleeding was examined also in the rat myocardium. The interaction between 0.1 ml/kg of perflutren and US exposure did not cause microvessel bleeding, and did not increase endothelial cell injury compared with the sham operation, unless frequent, strong US exposure occurred. When the dose was increased to 1.0 ml/kg, the combination of perflutren and US exposure resulted in capillary bleeding and increased endothelial cell injury in capillaries and venules (p<0.01). However, the incidence of microvessel bleeding and endothelial cell injury did not exceed that with Levovist microbubbles. In the myocardium, microvessel bleeding was not observed under any conditions. In conclusion, perflutren lipid microspheres enhanced US-related microvessel injury as with other contrast agents at the dose of 1.0 ml/kg, but not with 0.1 ml/kg and the appropriate US setting.<br />
DOI: 10.1253/circj.67.630 PMID: 12845189.
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