Contrast Injection from an Intermediate Catheter Placed in an Intradural Artery is Associated with Contrast-Induced Encephalopathy following Neurointervention

Fuga, Michiyasu; Tanaka, Toshihide; Tachi, Rintaro; Yamana, Satoshi; Irie, Koreaki; Kajiwara, Ikki; Teshigawara, Akihiko; Ishibashi, Toshiyuki; Hasegawa, Yuzuru; Murayama, Yuichi

doi:10.3174/ajnr.a7944

Cited by 5 publications

(2 citation statements)

References 24 publications

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“…Clinically, CIN has been observed to manifest following contrast administration in a range of settings, including CT [ 63 ], cerebral angiography [ 4 ], and coronary procedures [ 64 ]. The reported incidence of CIN following cerebral angiography ranges from 0.24 to 3.5% [ 6 , 9 , 10 , 65 ]. On the other hand, following coronary angiography, one study reported an incidence of 0.15% [ 66 ].…”

Section: Disruption Of the Bbbmentioning

confidence: 99%

“…This becomes an especially significant concern in neurovascular procedures, in which ischaemic stroke is a known complication and closely resembles the symptomatology of CIN. The incidence of CIN has been estimated to be approximately 0.5% [ 8 ]; however, particularly following neurointervention, the rate of CIN has been reported to be as high as 3.5% [ 9 , 10 ]. The symptoms of CIN are typically transient, although there have been reports of long-term neurological deficits and even death [ 7 , 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

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Pathophysiology of Contrast-Induced Neurotoxicity: A Narrative Review of Possible Mechanisms

Mariajoseph,

Lai,

Moore

et al. 2023

Eur Neurol

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Background: Contrast-induced neurotoxicity (CIN) is an increasingly observed event following the administration of iodinated contrast. It presents as a spectrum of neurological symptoms, that closely mimic ischaemic stroke, however, CIN remains poorly understood clinical phenomenon. An appreciation of underlying pathophysiological mechanisms is essential to improve clinical understanding and enhance decision making. Methods: A broad literature search of Medline (1946 to December 2022) and Embase (1947 to December 2022) was conducted. Articles discussing the pathophysiology of CIN were reviewed. Summary: Under normal circumstances, contrast agents do not pass the blood-brain barrier. Proposed mechanisms of CIN include blood-brain barrier (BBB) disruption due to factors including ischaemic stroke, uncontrolled hypertension, and possibly contrast agents themselves, amongst others. This is followed by passage of contrast agents across the BBB leading to chemotoxic sequelae of on neural tissue. Key Messages: This review provides a clinically-oriented review on the pathophysiology of CIN to enhance knowledge and improve decision making amongst clinicians.

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Section: Disruption Of the Bbbmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pathophysiology of Contrast-Induced Neurotoxicity: A Narrative Review of Possible Mechanisms

Mariajoseph,

Lai,

Moore

et al. 2023

Eur Neurol

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Incidence of contrast-induced neurotoxicity following endovascular treatment of unruptured intracranial aneurysms: a single-centre cohort study

Mariajoseph,

Lai,

Moore

et al. 2024

Acta Neurol Belg

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Background Contrast-induced neurotoxicity (CIN) is a recognised complication of endovascular procedures and has been increasingly observed in recent years. Amongst other clinical gaps, the precise incidence of CIN is unclear, particularly following intracranial interventional procedures. Methods A retrospective study of consecutive patients undergoing elective endovascular treatment of unruptured intracranial aneurysms (UIAs) was performed. Patients with previously ruptured aneurysms were excluded. The primary aim of this study was to determine the incidence of CIN following endovascular UIA treatment. Our secondary aim was to isolate potential predictive factors for developing CIN. Results From 2017 to 2023, a total of 158 patients underwent endovascular UIA treatment, with a median age of 64 years (IQR: 54–72), and 70.3% of female sex. Over the study period, the crude incidence of CIN was 2.5% (95% CI: 0.7 – 6.4%). The most common clinical manifestation of CIN was confusion (75%) and seizures (50%). Statistical analysis was conducted, and prolonged procedural duration was found be significantly associated with developing CIN (OR 12.55; p = 0.030). Conclusion Clinicians should be aware of the risk of CIN following endovascular neurointervention, particularly following technically challenging cases resulting in prolonged procedural time.

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Iohexol/iopamidol

2023

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Contrast Injection from an Intermediate Catheter Placed in an Intradural Artery is Associated with Contrast-Induced Encephalopathy following Neurointervention

Cited by 5 publications

References 24 publications

Pathophysiology of Contrast-Induced Neurotoxicity: A Narrative Review of Possible Mechanisms

Pathophysiology of Contrast-Induced Neurotoxicity: A Narrative Review of Possible Mechanisms

Incidence of contrast-induced neurotoxicity following endovascular treatment of unruptured intracranial aneurysms: a single-centre cohort study

Iohexol/iopamidol

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