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<meta name="DC.Title" content="The Risk of Acute Radiocontrast-Mediated Kidney Injury Following Endovascular Therapy for Acute Ischemic Stroke Is Low" />
<meta name="DC.Identifier" content="10.3174/ajnr.A2136" />
<meta name="DC.Date" content="2010-10-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="Copyright © American Society of Neuroradiology" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Endovascular therapy is an alternative for the treatment of AIS resulting from large intracranial arterial occlusions that depends on the use of iodinated RCM. The risk of RCM-mediated AKI following endovascular therapy for AIS may be different from that following coronary interventions because patients may not have identical risk factors.

MATERIALS AND METHODS: All consecutive patients with large-vessel AIS undergoing endovascular therapy were prospectively recorded. We recorded the baseline kidney function, and RCM-AKI was assessed according to the AKIN criteria at 48 hours after RCM administration. We compared the rate of RCM-AKI 48 hours after the procedure and sought to determine whether any preexisting factors increased the risk of RCM-AKI.

RESULTS: We identified 99 patients meeting inclusion criteria. The average volume of contrast was 189 ± 71 mL, and the average creatinine change was −4.6% at 48 hours postangiography. There were 3 patients with RCM-AKI. Although all 3 patients died as a result of their strokes, return to baseline creatinine levels occurred before death. There was a trend toward higher rates of premorbid diabetes mellitus, chronic renal insufficiency, preadmission statin and NSAID use, and a higher serum creatinine level on admission for the RCM-AKI group. The volume of procedural contrast was similar between groups (those with and those without RCM-AKI) ( P = .5).

CONCLUSIONS: In this small study, the rate of RCM-AKI following endovascular intervention for AIS was very low. A much larger study is required to determine its true incidence.

ACS
:   acute coronary syndrome
AIS
:   acute ischemic stroke
AKI
:   acute kidney injury
AKIN
:   Acute Kidney Injury Network
CAS
:   carotid angioplasty and stenting
IA
:   intra-arterial
IQR
:   interquartile range
MERCI
:   Mechanical Embolus Removal in Cerebral Ischemia
mRS
:   modified Rankin Scale
NSAID
:   nonsteroidal anti-inflammatory drug
NSD
:   not sufficient data for P value computation
PROACT
:   Prolyse in Acute Cerebral Thromboembolism
RCM
:   radiocontrast media
tPA
:   tissue plasminogen activator" />
<meta name="DC.Contributor" content="Y. Loh" />
<meta name="DC.Contributor" content="D.L. McArthur" />
<meta name="DC.Contributor" content="P. Vespa" />
<meta name="DC.Contributor" content="Z.-S. Shi" />
<meta name="DC.Contributor" content="D.S. Liebeskind" />
<meta name="DC.Contributor" content="R. Jahan" />
<meta name="DC.Contributor" content="N.R. Gonzalez" />
<meta name="DC.Contributor" content="S. Starkman" />
<meta name="DC.Contributor" content="J.L. Saver" />
<meta name="DC.Contributor" content="S. Tateshima" />
<meta name="DC.Contributor" content="G.R. Duckwiler" />
<meta name="DC.Contributor" content="F. Viñuela" />
<meta name="article:published_time" content="2010-10-01" />
<meta name="article:section" content="Patient Safety" />
<meta name="citation_title" content="The Risk of Acute Radiocontrast-Mediated Kidney Injury Following Endovascular Therapy for Acute Ischemic Stroke Is Low" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Endovascular therapy is an alternative for the treatment of AIS resulting from large intracranial arterial occlusions that depends on the use of iodinated RCM. The risk of RCM-mediated AKI following endovascular therapy for AIS may be different from that following coronary interventions because patients may not have identical risk  factors.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;All consecutive patients with large-vessel AIS undergoing endovascular therapy were prospectively recorded. We recorded the baseline kidney function, and RCM-AKI was assessed according to the AKIN criteria at 48 hours after RCM administration. We compared the rate of RCM-AKI 48 hours after the procedure and sought to determine whether any preexisting factors increased the risk of  RCM-AKI.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;We identified 99 patients meeting inclusion criteria. The average volume of contrast was 189 ± 71 mL, and the average creatinine change was −4.6% at 48 hours postangiography. There were 3 patients with RCM-AKI. Although all 3 patients died as a result of their strokes, return to baseline creatinine levels occurred before death. There was a trend toward higher rates of premorbid diabetes mellitus, chronic renal insufficiency, preadmission statin and NSAID use, and a higher serum creatinine level on admission for the RCM-AKI group. The volume of procedural contrast was similar between groups (those with and those without RCM-AKI) (&lt;i&gt;P&lt;/i&gt; = .5).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;In this small study, the rate of RCM-AKI following endovascular intervention for AIS was very low. A much larger study is required to determine its true  incidence.&lt;/p&gt;" />
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<meta name="twitter:title" content="The Risk of Acute Radiocontrast-Mediated Kidney Injury Following Endovascular Therapy for Acute Ischemic Stroke Is Low" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Endovascular therapy is an alternative for the treatment of AIS resulting from large intracranial arterial occlusions that depends on the use of iodinated RCM. The risk of RCM-mediated AKI following endovascular therapy for AIS may be different from that following coronary interventions because patients may not have identical risk factors.

MATERIALS AND METHODS: All consecutive patients with large-vessel AIS undergoing endovascular therapy were prospectively recorded. We recorded the baseline kidney function, and RCM-AKI was assessed according to the AKIN criteria at 48 hours after RCM administration. We compared the rate of RCM-AKI 48 hours after the procedure and sought to determine whether any preexisting factors increased the risk of RCM-AKI.

RESULTS: We identified 99 patients meeting inclusion criteria. The average volume of contrast was 189 ± 71 mL, and the average creatinine change was −4.6% at 48 hours postangiography. There were 3 patients with RCM-AKI. Although all 3 patients died as a result of their strokes, return to baseline creatinine levels occurred before death. There was a trend toward higher rates of premorbid diabetes mellitus, chronic renal insufficiency, preadmission statin and NSAID use, and a higher serum creatinine level on admission for the RCM-AKI group. The volume of procedural contrast was similar between groups (those with and those without RCM-AKI) ( P = .5).

CONCLUSIONS: In this small study, the rate of RCM-AKI following endovascular intervention for AIS was very low. A much larger study is required to determine its true incidence.

ACS
:   acute coronary syndrome
AIS
:   acute ischemic stroke
AKI
:   acute kidney injury
AKIN
:   Acute Kidney Injury Network
CAS
:   carotid angioplasty and stenting
IA
:   intra-arterial
IQR
:   interquartile range
MERCI
:   Mechanical Embolus Removal in Cerebral Ischemia
mRS
:   modified Rankin Scale
NSAID
:   nonsteroidal anti-inflammatory drug
NSD
:   not sufficient data for P value computation
PROACT
:   Prolyse in Acute Cerebral Thromboembolism
RCM
:   radiocontrast media
tPA
:   tissue plasminogen activator" />
<meta name="og-title" property="og:title" content="The Risk of Acute Radiocontrast-Mediated Kidney Injury Following Endovascular Therapy for Acute Ischemic Stroke Is Low" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/31/9/1584" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Endovascular therapy is an alternative for the treatment of AIS resulting from large intracranial arterial occlusions that depends on the use of iodinated RCM. The risk of RCM-mediated AKI following endovascular therapy for AIS may be different from that following coronary interventions because patients may not have identical risk factors.

MATERIALS AND METHODS: All consecutive patients with large-vessel AIS undergoing endovascular therapy were prospectively recorded. We recorded the baseline kidney function, and RCM-AKI was assessed according to the AKIN criteria at 48 hours after RCM administration. We compared the rate of RCM-AKI 48 hours after the procedure and sought to determine whether any preexisting factors increased the risk of RCM-AKI.

RESULTS: We identified 99 patients meeting inclusion criteria. The average volume of contrast was 189 ± 71 mL, and the average creatinine change was −4.6% at 48 hours postangiography. There were 3 patients with RCM-AKI. Although all 3 patients died as a result of their strokes, return to baseline creatinine levels occurred before death. There was a trend toward higher rates of premorbid diabetes mellitus, chronic renal insufficiency, preadmission statin and NSAID use, and a higher serum creatinine level on admission for the RCM-AKI group. The volume of procedural contrast was similar between groups (those with and those without RCM-AKI) ( P = .5).

CONCLUSIONS: In this small study, the rate of RCM-AKI following endovascular intervention for AIS was very low. A much larger study is required to determine its true incidence.

ACS
:   acute coronary syndrome
AIS
:   acute ischemic stroke
AKI
:   acute kidney injury
AKIN
:   Acute Kidney Injury Network
CAS
:   carotid angioplasty and stenting
IA
:   intra-arterial
IQR
:   interquartile range
MERCI
:   Mechanical Embolus Removal in Cerebral Ischemia
mRS
:   modified Rankin Scale
NSAID
:   nonsteroidal anti-inflammatory drug
NSD
:   not sufficient data for P value computation
PROACT
:   Prolyse in Acute Cerebral Thromboembolism
RCM
:   radiocontrast media
tPA
:   tissue plasminogen activator" />
<meta name="og-type" property="og:type" content="article" />
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      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">Patient Safety</span></span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-series highwire-cite-metadata">F</span></div>
  
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      <h1 class="highwire-cite-title" id="page-title">The Risk of Acute Radiocontrast-Mediated Kidney Injury Following Endovascular Therapy for Acute Ischemic Stroke Is Low</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">Y. Loh</span>, <span class="highwire-citation-author" data-delta="1">D.L. McArthur</span>, <span class="highwire-citation-author" data-delta="2">P. Vespa</span>, <span class="highwire-citation-author" data-delta="3">Z.-S. Shi</span>, <span class="highwire-citation-author" data-delta="4">D.S. Liebeskind</span>, <span class="highwire-citation-author" data-delta="5">R. Jahan</span>, <span class="highwire-citation-author" data-delta="6">N.R. Gonzalez</span>, <span class="highwire-citation-author" data-delta="7">S. Starkman</span>, <span class="highwire-citation-author" data-delta="8">J.L. Saver</span>, <span class="highwire-citation-author" data-delta="9">S. Tateshima</span>, <span class="highwire-citation-author" data-delta="10">G.R. Duckwiler</span> and <span class="highwire-citation-author" data-delta="11">F. Viñuela</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">October 2010,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">31 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(9) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1584-1587; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A2136 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-9845--639297978" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">Y. Loh </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Y.%2BLoh%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Loh%20Y&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AY.%2BLoh%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">D.L. 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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 31</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 9 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Oct 2010 </div></div>
      
      
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Oct 2010, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">31 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(9) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1584-1587; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A2136 </span></div>
  
  
  
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Oct 2010, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">31 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(9) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1584-1587; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A2136 </span></div>
  
  
  
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