BACKGROUND AND PURPOSE: Multimodal CT imaging with contrast-enhanced CT angiography (CTA) and CT perfusion (CTP) is increasingly being used to guide emergency management of acute stroke. However, little has been reported about the safety of intravenous contrast administration associated with these studies in the acute stroke population, including cases in which baseline creatinine values are unknown. We investigated the incidence of contrast-induced nephropathy (CIN), defined as a 25% or more increase in baseline creatinine levels within 72 hours of contrast administration and chronic kidney disease in patients receiving CTA+/-CTP at our regional stroke center. MATERIALS AND METHODS: We analyzed 198 patients who underwent contrast CT studies for evaluation of acute ischemic or hemorrhagic stroke at our center (2003-2007). Through retrospective chart abstraction, we analyzed serial creatinine levels (baseline to day 3) and later values (>/=day 4) where available. The incidences of CIN and/or chronic kidney disease were documented. After power analysis, CIN and non-CIN groups were compared by using the unpaired t test, Wilcoxon rank sum test, or Fisher exact test. RESULTS: None of the 198 patients developed chronic kidney disease or required dialysis. Of 175 patients with serial creatinine measurements between baseline and day 3, 5 (2.9%) developed CIN. The incidence of CIN was 2% in patients who were scanned before a baseline creatinine level was available. CONCLUSION: The incidence of renal sequelae is relatively low in acute stroke patients undergoing emergent multimodal CT scanning. Prompt CTA/CTP imaging of acute stroke, if indicated, need not be delayed in those with no history of renal impairment.
BACKGROUND AND PURPOSE: Multimodal CT imaging with contrast-enhanced CT angiography (CTA) and CT perfusion (CTP) is increasingly being used to guide emergency management of acute stroke. However, little has been reported about the safety of intravenous contrast administration associated with these studies in the acute stroke population, including cases in which baseline creatinine values are unknown. We investigated the incidence of contrast-induced nephropathy (CIN), defined as a 25% or more increase in baseline creatinine levels within 72 hours of contrast administration and chronic kidney disease in patients receiving CTA+/-CTP at our regional stroke center. MATERIALS AND METHODS: We analyzed 198 patients who underwent contrast CT studies for evaluation of acute ischemic or hemorrhagic stroke at our center (2003-2007). Through retrospective chart abstraction, we analyzed serial creatinine levels (baseline to day 3) and later values (>/=day 4) where available. The incidences of CIN and/or chronic kidney disease were documented. After power analysis, CIN and non-CIN groups were compared by using the unpaired t test, Wilcoxon rank sum test, or Fisher exact test. RESULTS: None of the 198 patients developed chronic kidney disease or required dialysis. Of 175 patients with serial creatinine measurements between baseline and day 3, 5 (2.9%) developed CIN. The incidence of CIN was 2% in patients who were scanned before a baseline creatinine level was available. CONCLUSION: The incidence of renal sequelae is relatively low in acute strokepatients undergoing emergent multimodal CT scanning. Prompt CTA/CTP imaging of acute stroke, if indicated, need not be delayed in those with no history of renal impairment.
Authors: E M Lautin; N J Freeman; A H Schoenfeld; C W Bakal; N Haramati; A C Friedman; J L Lautin; S Braha; E G Kadish; S Sprayregen Journal: AJR Am J Roentgenol Date: 1991-07 Impact factor: 3.959
Authors: Charanjit S Rihal; Stephen C Textor; Diane E Grill; Peter B Berger; Henry H Ting; Patricia J Best; Mandeep Singh; Malcolm R Bell; Gregory W Barsness; Verghese Mathew; Kirk N Garratt; David R Holmes Journal: Circulation Date: 2002-05-14 Impact factor: 29.690
Authors: John R Sims; Guy Rordorf; Eric E Smith; Walter J Koroshetz; Michael H Lev; Ferdinando Buonanno; Lee H Schwamm Journal: AJNR Am J Neuroradiol Date: 2005-02 Impact factor: 3.825
Authors: Peter Aspelin; Pierre Aubry; Sven-Göran Fransson; Ruth Strasser; Roland Willenbrock; Knut Joachim Berg Journal: N Engl J Med Date: 2003-02-06 Impact factor: 91.245
Authors: Steve Gazzola; Richard I Aviv; David J Gladstone; Gabriella Mallia; Vivian Li; Allan J Fox; Sean P Symons Journal: Stroke Date: 2008-02-21 Impact factor: 7.914
Authors: Stephan P Kloska; Ralf Dittrich; Tobias Fischer; Darius G Nabavi; Roman Fischbach; Peter Seidensticker; Nani Osada; E Bernd Ringelstein; Walter Heindel Journal: Eur Radiol Date: 2007-06-05 Impact factor: 7.034
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