Contrast-induced neurotoxicity after coronary angiography

Kocabay, Gönenç; Karabay, Can Yücel; Kalaycı, Arzu; Akgün, Taylan; Güler, Ahmet; Oduncu, Vecih; Tanboğa, İbrahi̇m Hali̇l; Izgi, Akin; Kırma, Cevat

doi:10.1007/s00059-013-3871-6

Cited by 49 publications

(52 citation statements)

References 23 publications

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“…CIE is more commonly associated with cerebral or carotid angiography. Besides transient cortical blindness, there are several other clinical manifestations that have been reported, including encephalopathy, hemiparesis, seizures, as well as aphasia [1-15]. Neurological deficits are usually self-limiting but have rarely been shown to be persistent [18].…”

Section: Discussionmentioning

confidence: 99%

“…CIE is a very rare complication following contrast administration that presents with neurological deficit that is usually self-limiting [1-15]. It was first reported in 1970, manifesting as transient cortical blindness following CAG [12].…”

Section: Discussionmentioning

confidence: 99%

“…Larger doses of iodinated contrast is considered a risk factor [19]. One study proposed 170 mL as the maximal recommended dose for coronary angiograms to prevent CIE [1]. However, very small doses of contrast media – as little as 25 mL – for local injection into the carotid artery have been reported to cause CIE [20].…”

Section: Discussionmentioning

confidence: 99%

“…All types of contrast media, including ionic, non-ionic, low osmolarity, iso-osmolar, and high osmolarity, have been reported to induce CIE [1-15]. Clinical manifestations include encephalopathy, seizures, transient cortical blindness, and focal neurological deficits, which gives rise to a broad differential diagnosis.…”

Section: Introductionmentioning

confidence: 99%

“…Contrast-induced encephalopathy (CIE) is a very rare complication of coronary angiography (CAG) [1]. All types of contrast media, including ionic, non-ionic, low osmolarity, iso-osmolar, and high osmolarity, have been reported to induce CIE [1-15].…”

Section: Introductionmentioning

confidence: 99%

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Contrast-Induced Encephalopathy following Coronary Angiography with No Radiological Features: A Case Report and Literature Review

Dattani

Tay

et al. 2018

Cardiology

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Contrast-induced encephalopathy (CIE) following coronary angiography (CAG) is a very rare complication. Radiological signs such as cerebral oedema and cortical enhancement are of great importance in the diagnosis. We report a case of probable CIE in a 76-year-old gentleman following a normal diagnostic CAG that involved 120 mL of the iodinated contrast agent iohexol (Omnipaque 300). At 90 min postprocedure he became acutely confused with a normal non-contrast CT of the head. After 9 days of conservative treatment, the patient recovered spontaneously with no neurological deficits. This case and a review of the literature highlights that contrast-induced neurotoxicity may not always present with the typical radiological signs that are described in association with CIE. Given the excellent prognosis with supportive management only, interventional cardiologists should be well aware of this condition despite the absence of radiological features.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Contrast-Induced Encephalopathy following Coronary Angiography with No Radiological Features: A Case Report and Literature Review

Dattani

Tay

et al. 2018

Cardiology

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Contrast‐induced encephalopathy following cardiac catheterization

Spina

Simon

Markus

et al. 2016

Cathet Cardio Intervent

107

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M a i l i n g A d d r e s s : F r e d e r i c o T. U l t r a m a r i @@@@@@@@@@@@@@@@@@@@@@@@@@@ It is estimated that 6,000 and 2,000 cardiac catheterization procedures per million inhabitants/year are performed in Western countries for diagnostic and therapeutic purposes. In order to perform these procedures, 1,800 tons of iodine are required all over the world to manufacture contrast media (CM). The number of procedures that require the use of contrast media (or dye) has increased over time, and the population submitted to it is growing older, presenting more comorbidities 1, 2. Currently low-osmolar contrast media are used in approximately 75% of patients and the iso-osmolar contrast media, allegedly less toxic are becoming more popular 1. In spite of development of new contrast media, they still represent the third main cause of nosocomial-acquired acute renal failure (ARF) (10% of cases), substantially increasing hospitalization period, care costs and in-hospital morbi-mortality 3-6. The main goal is to address important aspects about the contrast-medium induced nephropathy (CMIN) that follows cardiac catheterization, including its definition, pathogenesis, incidence, risk factors, clinical picture, prevention, treatment and prognosis.

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