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RT Journal Article
SR Electronic
T1 The Risk of Acute Radiocontrast-Mediated Kidney Injury Following Endovascular Therapy for Acute Ischemic Stroke Is Low
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1584
OP 1587
DO 10.3174/ajnr.A2136
VO 31
IS 9
A1 Loh, Y.
A1 McArthur, D.L.
A1 Vespa, P.
A1 Shi, Z.-S.
A1 Liebeskind, D.S.
A1 Jahan, R.
A1 Gonzalez, N.R.
A1 Starkman, S.
A1 Saver, J.L.
A1 Tateshima, S.
A1 Duckwiler, G.R.
A1 Viñuela, F.
YR 2010
UL http://www.ajnr.org/content/31/9/1584.abstract
AB 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. ACSacute coronary syndromeAISacute ischemic strokeAKIacute kidney injuryAKINAcute Kidney Injury NetworkCAScarotid angioplasty and stentingIAintra-arterialIQRinterquartile rangeMERCIMechanical Embolus Removal in Cerebral IschemiamRSmodified Rankin ScaleNSAIDnonsteroidal anti-inflammatory drugNSDnot sufficient data for P value computationPROACTProlyse in Acute Cerebral ThromboembolismRCMradiocontrast mediatPAtissue plasminogen activator