Contrast-Induced Encephalopathy After Endovascular Thrombectomy for Acute Ischemic Stroke
Contrast-Induced Encephalopathy After Endovascular Thrombectomy for Acute Ischemic Stroke
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DOI：
10.1161/strokeaha.120.031518
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发表时间：
2020-12-01
期刊：
影响因子：
8.3
通讯作者：
Jeng, Jiann-Shing
中科院分区：
文献类型：
--
作者：
Chu, Yung-Tsai;Lee, Kang-Po;Jeng, Jiann-Shing
背景和目的：造影剂诱发脑病(CIE)是急性缺血性卒中血管内取栓术(EVT)后一种罕见且未被充分认识的并发症。方法：选择2014年9月至2019年12月在2个医学中心接受EVT治疗的急性缺血性卒中患者。结果：421例接受EVT治疗的急性缺血性卒中患者中，7例(1.7%)发生CIE，临床诊断标准为术后24小时内出现神经功能恶化或迟缓改善，但不能通过梗死灶或出血性改变来解释。表现包括局灶性神经体征恶化、昏迷和癫痫。有CIE的患者比无CIE的患者更容易发生造影剂引起的急性肾损伤，但造影剂的体积在两组之间是相似的。CIE的独立危险因素包括肾功能障碍(定义为估计的肾小球滤过率
Background and Purpose:Contrast-induced encephalopathy (CIE) is a rare and underrecognized complication after endovascular thrombectomy (EVT) for acute ischemic stroke. This study investigated the incidence and risk factors of CIE in patients who underwent EVT.Methods:Consecutive patients with acute ischemic stroke who received EVT between September 2014 and December 2019 at 2 medical centers were included. CIE was diagnosed on clinical criteria of neurological deterioration or delayed improvement within 24 hours after the procedure that was unexplained by the infarct or hemorrhagic transformation and radiological criterion of edematous change extending beyond the infarct core accompanied by contrast staining.Results:Of 421 patients with acute ischemic stroke who received EVT, 7 (1.7%) developed CIE. The manifestations included worsening of focal neurological signs, coma, and seizure. Patients with CIE were more likely to experience contrast-induced acute kidney injury than were those without CIE, but the volume of contrast medium was comparable between the two groups. The independent risk factors for CIE included renal dysfunction (defined as an estimated glomerular filtration rate