The Risk of Acute Radiocontrast-Mediated Kidney Injury Following Endovascular Therapy for Acute Ischemic Stroke Is Low

Abstract

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.

Risk of contrast-induced nephropathy in patients undergoing endovascular treatment of acute ischemic stroke

“…None of the patients without a previous history of chronic kidney disease developed CIN 30. Loh et al 32 reported an incidence of acute CIN of 3% in a cohort of 99 patients undergoing endovascular therapy for acute ischemic stroke.…”

Incidence of Contrast Material–induced Nephropathy after Neuroendovascular Procedures

“…Most of the data on CIN risk factors comes from cardiac literature (2)(3)(4). To our knowledge, there are only two studies that examined the incidence of CM-induced kidney injury following endovascular treatment for acute ischemic stroke to date (5,6). Furthermore, the average volume of CM administered in the cardiac and neurovascular literature ranges from 235 to 265 mL and 150 to 189 mL, respectively (5)(6)(7)(8)(9).…”

“…To our knowledge, there are only two studies that examined the incidence of CM-induced kidney injury following endovascular treatment for acute ischemic stroke to date (5,6). Furthermore, the average volume of CM administered in the cardiac and neurovascular literature ranges from 235 to 265 mL and 150 to 189 mL, respectively (5)(6)(7)(8)(9). For this reason, we aim to define the risk of CIN in patients who receive a relatively high dose of CM during neuroendovascular procedures.…”

Prolonged Carotid Sinus Reflex Is a Risk Factor for Contrast-Induced Nephropathy following Carotid Artery Stenting

“…While CIN has been reported to occur mainly in association with coronary procedures, several studies have described the incidence of CIN after CTA, CTP, and catheter intervention in patients with stroke. [24][25][26][27][28][29][30] CIN occurred in 3% of cases (7/224) within 5 days in patients with acute stroke syndrome who underwent CTA within 24 hours from the onset of symptoms. 24 With the use of CTA and CTP to guide emergency management of acute stroke, CIN occurred in 2.9% of 175 patients within 72 hours.…”