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COMMENTARY Save the Brain First: CTA and Mechanical Thrombectomy in Patients at Risk for Contrast-Induced Nephropathy troke is one of the most common diseases affecting 800,000 Furthermore, the cutoff eGFR value for an increased CIN risk was SAmericans each year. It ranks fourth among all-cause mortal- found to be 43 mL/min/1.73 m . Most important, there was no ity in the United States. When patients present with stroke-like reported mortality in the patients with CIN. Only 5 patients symptoms, the current American Heart Association/American underwent dialysis, and all patients fully recovered renal function Stroke Association (AHA/ASA) guidelines recommend an imme- within 4 days. Due to its retrospective observational nature, in this diate non-contrast CT of the head. If large-vessel occlusion is sus- study, a causal relationship could not be established between intra- pected, CTA or MRA should be performed to assess the vascular venous contrast and CIN. Furthermore, the absolute CIN inci- anatomy and plan for endovascular therapy. If the patient is a dence rate in patients with CKD was low. Patients with severe candidate for mechanical thrombectomy, cerebral angiography is CKD were at an increased risk of CIN. However, the clinical con- performed. Both CTA and mechanical thrombectomy
American Journal of Neuroradiology – American Journal of Neuroradiology
Published: Apr 1, 2020
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