The risk of acute radiocontrast-mediated kidney injury following endovascular therapy for acute ischemic stroke is low.
OBJECTIVE
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.


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.
Loh
Y
Y
Division of Neurosurgery, David Geffen School of Medicine at the University of California at Los Angeles, CA, USA. yincer@yahoo.com
McArthur
D L
DL
Vespa
P
P
Shi
Z-S
ZS
Liebeskind
D S
DS
Jahan
R
R
Gonzalez
N R
NR
Starkman
S
S
Saver
J L
JL
Tateshima
S
S
Duckwiler
G R
GR
Viñuela
F
F
D058186:Acute Kidney Injury / Q000000981:diagnostic imaging / Q000401:mortality*; D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000401:mortality* / Q000628:therapy*; D015897:Comorbidity; D003287:Contrast Media; D004621:Embolization, Therapeutic / Q000401:mortality*; D005260:Female; D006801:Humans; D015994:Incidence; D007457:Iodine Radioisotopes; D008297:Male; D008875:Middle Aged; D011859:Radiography; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000000981:diagnostic imaging / Q000401:mortality* / Q000628:therapy*; D016019:Survival Analysis; D015996:Survival Rate; D014861:Washington / Q000453:epidemiology
D003287:Contrast Media; D007457:Iodine Radioisotopes