PT  - JOURNAL ARTICLE
AU  - Loh, Y.
AU  - McArthur, D.L.
AU  - Vespa, P.
AU  - Shi, Z.-S.
AU  - Liebeskind, D.S.
AU  - Jahan, R.
AU  - Gonzalez, N.R.
AU  - Starkman, S.
AU  - Saver, J.L.
AU  - Tateshima, S.
AU  - Duckwiler, G.R.
AU  - Viñuela, F.
TI  - The Risk of Acute Radiocontrast-Mediated Kidney Injury Following Endovascular Therapy for Acute Ischemic Stroke Is Low
AID  - 10.3174/ajnr.A2136
DP  - 2010 Oct 01
TA  - American Journal of Neuroradiology
PG  - 1584--1587
VI  - 31
IP  - 9
4099  - http://www.ajnr.org/content/31/9/1584.short
4100  - http://www.ajnr.org/content/31/9/1584.full
SO  - Am. J. Neuroradiol.2010 Oct 01; 31
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