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Contrast Injection from an Intermediate Catheter Placed in an Intradural Artery is Associated with Contrast-Induced Encephalopathy following Neurointervention

医学 对比度(视觉) 血管造影 脑病 放射科 逻辑回归 脑血管造影 导管 单变量分析 造影剂 外科 多元分析 内科学 计算机科学 人工智能
作者
Michiyasu Fuga,Toshihide Tanaka,Rintaro Tachi,Satoshi Yamana,Koreaki Irie,Ikki Kajiwara,Akihiko Teshigawara,Toshihiro Ishibashi,Yuzuru Hasegawa,Yuichi Murayama
出处
期刊:American Journal of Neuroradiology [American Society of Neuroradiology]
卷期号:44 (9): 1057-1063 被引量:3
标识
DOI:10.3174/ajnr.a7944
摘要

BACKGROUND AND PURPOSE:

Contrast-induced encephalopathy can result from neurotoxicity of contrast medium in the affected area. The development of intermediate catheters has allowed guidance of catheters to more distal arteries. This study focused on the association between contrast-induced encephalopathy and contrast injection from an intermediate catheter guided into a distal intradural artery during neurointervention for cerebral aneurysms.

MATERIALS AND METHODS:

We retrospectively reviewed 420 consecutive aneurysms in 396 patients who underwent neurointervention for extracranial aneurysms and unruptured intracranial aneurysms at our institution from February 2012 to January 2023. Patients were divided into a group with contrast-induced encephalopathy and a group without. To identify risk factors for contrast-induced encephalopathy, we compared clinical, anatomic, and procedural factors between groups by multivariate logistic regression analysis and stepwise selection.

RESULTS:

Among the 396 patients who underwent neurointervention for cerebral aneurysms, 14 (3.5%) developed contrast-induced encephalopathy. Compared with the group without contrast-induced encephalopathy, the group with contrast-induced encephalopathy showed significantly higher rates of patients on hemodialysis, previously treated aneurysms, intradural placement of a catheter for angiography, nonionic contrast medium, and flow-diversion procedures in univariate analyses. Stepwise multivariate logistic regression analysis revealed intradural placement of a catheter for angiography (OR = 40.4; 95% CI, 8.63–189) and previously treated aneurysms (OR = 8.20; 95% CI, 2.26–29.6) as independent predictors of contrast-induced encephalopathy.

CONCLUSIONS:

Contrast injection from an intradural artery and retreatment of recurrent aneurysms were major risk factors for contrast-induced encephalopathy. Attention should be paid to the location of the intermediate catheter for angiography to avoid developing contrast-induced encephalopathy.
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