BACKGROUND AND PURPOSE: Minimal research has evaluated the renal safety of emergent computed tomography angiography (CTA) procedures, consecutive contrast medium application, and the long-term outcome in acute stroke patients. We investigated the incidence of contrast-induced renal impairment in these populations. METHODS: We retrospectively reviewed patients with acute stroke syndrome who received a CTA of the brain with or without the neck within 24 hours from onset of symptoms. All creatinine results and additional conventional angiography findings were recorded. With a positive history of renal disease, contrast administration was delayed until creatinine results were available. Radiocontrast nephropathy (RCN) was defined as a >/=25% increase in serum creatinine from the baseline value up to 5 days after CTA. RESULTS: Four hundred eighty-one patients were reviewed, and 224 met the inclusion criteria. There were 7 of 224 (3%) who fulfilled the criteria for RCN. A number of patients underwent emergent CTA without knowledge of their creatinine value; 2 of 93 (2%) developed RCN. There were 36 patients who received an additional digital subtraction angiogram, and none of these developed subsequent RCN. No patients required dialysis, and 9 of 68 (13%) had a >25% increase in their creatinine levels at a late (>30 days) follow-up. CONCLUSIONS: Overall, these results illustrate that there is a low incidence of RCN in acute stroke patients undergoing emergency CTA.
BACKGROUND AND PURPOSE: Minimal research has evaluated the renal safety of emergent computed tomography angiography (CTA) procedures, consecutive contrast medium application, and the long-term outcome in acute strokepatients. We investigated the incidence of contrast-induced renal impairment in these populations. METHODS: We retrospectively reviewed patients with acute stroke syndrome who received a CTA of the brain with or without the neck within 24 hours from onset of symptoms. All creatinine results and additional conventional angiography findings were recorded. With a positive history of renal disease, contrast administration was delayed until creatinine results were available. Radiocontrast nephropathy (RCN) was defined as a >/=25% increase in serum creatinine from the baseline value up to 5 days after CTA. RESULTS: Four hundred eighty-one patients were reviewed, and 224 met the inclusion criteria. There were 7 of 224 (3%) who fulfilled the criteria for RCN. A number of patients underwent emergent CTA without knowledge of their creatinine value; 2 of 93 (2%) developed RCN. There were 36 patients who received an additional digital subtraction angiogram, and none of these developed subsequent RCN. No patients required dialysis, and 9 of 68 (13%) had a >25% increase in their creatinine levels at a late (>30 days) follow-up. CONCLUSIONS: Overall, these results illustrate that there is a low incidence of RCN in acute strokepatients undergoing emergency CTA.
Authors: Bappaditya Ray; Kim L Rickert; Babu G Welch; Jonathan A White; Daniel R Klinger; Benjamin P Boudreaux; Brett A Whittemore; Eugene Gu Journal: Neurocrit Care Date: 2013-10 Impact factor: 3.210
Authors: A P Carlson; A M Brown; E Zager; K Uchino; M P Marks; C Robertson; G P Sinson; A Marmarou; H Yonas Journal: AJNR Am J Neuroradiol Date: 2011-06-23 Impact factor: 3.825
Authors: K D Vo; A J Yoo; A Gupta; Y Qiao; A S Vagal; J A Hirsch; D M Yousem; C Lum Journal: AJNR Am J Neuroradiol Date: 2015-10-01 Impact factor: 3.825