Contrast-induced nephropathy after peripheral vascular intervention: Long-term renal outcome and risk factors for progressive renal dysfunction

Adas, Ziad Al; Lodewyk, Kevin; Robinson, David M.; Qureshi, Sherazuddin; Kabbani, Loay; Sullivan, Brian; Shepard, Alexander D.; Weaver, Mitchell R.; Nypaver, Timothy J.

doi:10.1016/j.jvs.2018.06.196

Cited by 18 publications

(12 citation statements)

References 34 publications

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“…49 Interestingly, studies in patients who developed CI-AKI after peripheral vascular interventions also suggested that the magnitude as well as the duration of increased creatinine concentration correlated with late renal dysfunction. 50 Further studies would be of interest to investigate this in patients who underwent ch-EVAR.…”

Section: Discussionmentioning

confidence: 99%

Incidence of Contrast-Induced Nephropathy and Post-Operative Outcomes in Patients Undergoing Chimney Endovascular Aortic Aneurysm Repair

Caradu¹,

Coatsaliou²,

Colacchio³

et al. 2022

Angiology

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Chimney endovascular aortic aneurysm repair (ch-EVAR) has become a valid alternative to treat complex aneurysms but the occurrence of contrast-induced kidney injury (CI-AKI) is poorly known. This study investigated the incidence and the impact of CI-AKI on post-operative outcomes after ch-EVAR. Consecutive patients who underwent ch-EVAR between July 2010 and 2021 were retrospectively included. CI-AKI was defined based on plasma creatinine levels within 7 days after the intervention according to the “Kidney Disease Improving Global Outcomes” (KDIGO) classification. Among 102 patients included, CI-AKI occurred in 14 cases (13.7%). The 30-day post-operative mortality and complications were significantly higher in patients who developed CI-AKI compared with those who did not (50 vs 9.1%, P = .001 and 57.1 vs 20.5%, P = .007). Over a median follow-up of 24 months (3-39), overall mortality was also significantly higher (78.6 vs 33.0%, P = .002). The pre-operative platelet-to-lymphocyte ratio (PLR) was significantly higher in patients who developed CI-AKI (224.5 vs 147.6, P = .008). CI-AKI is frequent after ch-EVAR and is associated with worse post-operative outcomes. This should increase awareness of clinicians to optimize preventive and therapeutic strategies.

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Section: Discussionmentioning

confidence: 99%

Incidence of Contrast-Induced Nephropathy and Post-Operative Outcomes in Patients Undergoing Chimney Endovascular Aortic Aneurysm Repair

Caradu¹,

Coatsaliou²,

Colacchio³

et al. 2022

Angiology

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“…Hasta populasyonumuzun %11' ini kronik böbrek yetersizliği olan hastaların oluşturduğu göz önünde bulundurulduğunda beklenen bir sonuçtur. Bununla birlikte periferik arter hastalarında daha önce yapılan bir çalışmada geçici diyaliz ihtiyacı gelişen hasta oranı %0.6 olup benzer orana sahiptir (6) Dizaltı arter hastalığı prevelansı sık olmakla birlikte, kliniğimizde sadece anatomik olarak revaskülarizasyona uygun olan kritik bacak iskemisi ve/veya doku kaybı (Rutherford 4-6) olan hastalara müdahale edilmektedir. Bu nedenle dizaltı arter girişim sayıları nispeten az görülmektedir (1,8).…”

Section: Discussionunclassified

Endovascular treatment in lower extremity peripheral artery disease: A single center experience

Özen¹,

Turan²

2019

Kocaeli Med J

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Semptomatik alt ekstremite arter hastalığında endovasküler tedavi giderek artan önemle tedavide yerini almıştır. Çalışmamızda merkezimizin son 8 yılına ait perkütan işlem verilerinin retrospektif sunulması amaçlanmıştır. YÖNTEM ve GEREÇLER: Temmuz 2011 ile Aralık 2018 arası kliniğimizde yapılan alt ekstremite arterlerine yönelik girişimler geriye dönük tarandı. Demografik, laboratuvar ve işlem verileri hastane içi istenmeyen olaylar hasta kayıtlarından elde edilerek sunuldu. BULGULAR: 541 periferik arter girişimi tarandı. Toplamda 374 adet alt ekstremite arterine yönelik girişimde iliak (n=219), femoropliteal (n=184) ve tibial/peroneal (n=17) arterleri içeren 420 damara endovasküler tedavi çalışmaya dahil edildi. Genel işlem başarısı %97.1 olup işlem sayı ve başarısında yıllara göre belirgin artış izlendi. İliak ve femoropopliteal girişimlerde işlem başarısı %97' nin üzerinde iken tibioperoneal arter girişimlerinde %100 saptandı. Hastane içi istenmeyen ölüm 3 (%0.8), amputasyon 2 (%0.5), major kanama 2 (%0.5), diyaliz ihtiyacı 3 (%0.8) ve serebrovasküler olay (%0.3) saptandı. Hastaların %85' i işlem sonrası bir gün içinde taburcu edildi. TARTIŞMA ve SONUÇ: Alt ekstremite arter hastalıklarında endovasküler tedavi yıllar içinde giderek artan sayılarda yapılmaktadır. Teknik gelişmeler ve artan tecrübe yüksek başarı, makul komplikasyon oranları ve erken mobilizasyona imkan sağlamaktadır.

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“…Administration of radiocontrast during endovascular procedures for peripheral arterial disease (PAD) may cause AKI. Only patients who developed AKI, which was defined as an increase in serum creatinine concentration of > 0.5 mg/dL within 30 days after intervention, were included (881 pts) [122]. In this group, 57 patients (6.5%) developed AKI; 47% were male and 51% had baseline CKD.…”

Section: Peripheral Vascular Interventionmentioning

confidence: 99%

“…Using multivariate linear regression, male sex (p = 0.027) and congestive heart failure (p = 0.048) were associated with 1-year GFR decline. Periprocedural variables related to 1-year GFR decline included percentage increase in 30-day post procedural creatinine concentration (p = 0.025), whereas CIN resolution by discharge (mean, 13.1 days) was protective for renal function at 1-year observation (p = 0.02) [122]. Retrospective observational cohort study by Sigterman et al includes all patients who newly presented to the vascular surgery outpatient clinic with Rutherford class II or III PAD and who were treated with either supervised exercise therapy or endovascular interventions [123].…”

Section: Peripheral Vascular Interventionmentioning

confidence: 99%

Acute Renal Failure/Acute Kidney Injury (AKI) Associated with Endovascular Procedures

et al. 2020

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AKI is one of the most common yet underdiagnosed postoperative complications that can occur after any type of surgery. Contrast-induced nephropathy (CIN) is still poorly defined and due to a wide range of confounding individual variables, its risk is difficult to determine. CIN mainly affects patients with underlying chronic kidney disease, diabetes, sepsis, heart failure, acute coronary syndrome and cardiogenic shock. Further research is necessary to better understand pathophysiology of contrast-induced AKI and consequent implementation of effective prevention and therapeutic strategies. Although many therapies have been tested to avoid CIN, the only potent preventative strategy involves aggressive fluid administration and reduction of contrast volume. Regardless of surgical technique—open or endovascular—perioperative AKI is associated with significant morbidity, mortality and cost. Endovascular procedures always require administration of a contrast media, which may cause acute tubular necrosis or renal vascular embolization leading to renal ischemia and as a consequence, contribute to increased number of post-operative AKIs.

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Contrast-induced nephropathy after peripheral vascular intervention: Long-term renal outcome and risk factors for progressive renal dysfunction

Cited by 18 publications

References 34 publications

Incidence of Contrast-Induced Nephropathy and Post-Operative Outcomes in Patients Undergoing Chimney Endovascular Aortic Aneurysm Repair

Incidence of Contrast-Induced Nephropathy and Post-Operative Outcomes in Patients Undergoing Chimney Endovascular Aortic Aneurysm Repair

Endovascular treatment in lower extremity peripheral artery disease: A single center experience

Acute Renal Failure/Acute Kidney Injury (AKI) Associated with Endovascular Procedures

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