To the Editor.—
The total adoption of low-ionic contrast media is not likely, given the current economic limitations in this country. However, Dr Fischer's1 statement in his recent editorial that a universal changeover to these agents is not justified just to increase patient comfort may be misconstrued as a statement, potentially with legal ramifications, that these drugs are not indicated when they are to be used primarily to lessen pain and motion during radiographic procedures. This is certainly not the case.In my practice, I have no doubt that the decrease in the pain that patients experience during intra-arterial injection of high concentrations of the new, more expensive, agents, compared with the intense pain commonly experienced with the older high-osmolality drugs, warrants their routine use for almost all diagnostic and interventional angiographic procedures. I cannot ethically deny their use to my patients, since I would insist on the use
Gavant ML. Low-Osmolar Contrast Agents. JAMA. 1989;261(10):1441–1442. doi:10.1001/jama.1989.03420100075015
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