| Title: |
Contrast-Associated Acute Kidney Injury After Thrombectomy for Ischemic Stroke: Prognostic Impact and CAN-REST Predictive Score |
| Authors: |
Schwarz, Ghil; Cascio Rizzo, Angelo; Ambler, Gareth; Wrona, Pawel; Slowik, Agnieszka; Kotas, Szymonn; Doheim, Mohamed F; Al-Bayati, Alhamza R; Nogueira, Raul G; Nunes, Ana Paiva; Ferreira, Patricia; Paolucci, Matteo; Zini, Andrea; Simonetti, Luigi; Leško, Norbert; Fedorko, Jakub; Gdovinova, Zuzana; Scarcia, Luca; Kalsoum, Erwah; Farhat, Firas; Beyeler, Morin; Mujanovic, Adnan; Arnold, Marcel; Meira, Torcato; Morais, Marta; Francisco, Leonor; Wiacek, Marcin; Pudło, Paulina; Bartosik-Psujek, Halina; Calleja, Patricia; Ostos, Fernando; Seoane, David; Negrila, Anca; Radu, Razvan Alexandru; Tiu, Cristina; Al Kasab, Sami; Qdais, Ahmad Abu; Samman Tahhan, Imad; Ayo-Martin, Oscar; Paya, Maria; Molina-Nuevo, Juan David; Labuz-Roszak, Beata; Toni, Danilo; Moszko, Karolina; Roszak, Mateusz Łukasz; De Michele, Manuela; Barrile, Elena; Eswaradass, Prasanna; Houghton, Margaret; Barkley, Tiffany; Ali, Amir; Demeestere, Jelle; Bauknight, Wayne Martin; Sheth, Sunil; Maes, Louise; Wouters, Anke; Pedro Marto, João; Blazer Costa, Josè; Loizzo, Nicola D; Romi, Andrea; Currò, Carmelo Tiberio; Luchowski, Piotr; Seweryn, Maksymilian; Rejdak, Konrad; Klein, Piers; Abdalkader, Mohamad; Saia, Valentina; Sanna, Antioco; Tassinari, Tiziana; Acampa, Maurizio; Rosini, Francesca; Tassi, Rossana; Bilik, Marta; Bandzarewicz-Samcik, Anna Maria; Min, Jiangyong; HajAissa, Naser; Mangiardi, Marilena; Anticoli, Sabrina; Pampana, Enrico; Hervás-Testal, Carlos; Rigual, Ricardo; Fuentes, Blanca; Strambo, Davide; Tetaria, Carl Manuata; Saliou, Guillaume; Caramma, Andrea Salvatore; Maimone, Davide; Rizzo, Pier Andrea; Moci, Marco; Scala, Irene; Cruz-Culebras, Antonio; Vera Lechuga, Rocío; García-Madrona, Sebastián; Merlino, Giovanni; Valente, Mariarosaria; Cella, Arianna; Bolognese, Manuel; Lakatos, Lehel-Barna; Karwacki, Grzegorz M; Candelaresi, Paolo; Andreone, Vincenzo; Maurea, Carlo; Tarletti, Roberto; Mele, Angelica; Ciacciarelli, Antonio; Alessiani, Michele; Monteforte, Gabriella; Pakizer, David; Roubec, Martin; Školoudík, David; Vandervorst, Fenne; De Raedt, Sylvie; Verdam, Martijn; Bartoš, Josef; Sramek, Martin; Mazzoleni, Valentina; Quilici, Luca; Alimonti, Dario; Moller, Jessica; Maestrini, Ilaria; Diomedi, Marina; Lacidogna, Giordano; Zaidat, Osama O; Lin, Eugene; Almajali, Mohammad; Baracchini, Claudio; Zaccagnino, Matteo; Viaro, Federica; Pezzini, Alessandro; Avola, Giulia; Ferraro, Chiara; Świtońska, Milena; Sobieszak-Skura, Paulina; Meder, Grzegorz; Mayer-Suess, Lukas; Knoflach, Michael; Gizewski, Elke R; Common, Matthew R; Nicholson, Patrick; Power, Sarah; Nowakowska-Kotas, Marta; Puła, Michal; Guzinski, Maciej; Pérez-Sánchez, Soledad; Montaner, Joan; Bravo, Alexandra Sevilla; Marcheselli, Simona; Vodret, Francesca; Rapillo, Costanza Maria; Pereira, Liliana; Rodrigues, Miguel; Jaros, Adam; Kovar, Martin; Vojik, Jan; Valcamonica, Gloria; Cassarino, Serena Gallo; Cardillo, Alessandra; Petruzzellis, Marco; Grimaldi, Silvia; Marrone, Nicola; Hassan, Ameer E; Miller, Samantha; Khasawneh, Mohammad W; Poretto, Valentina; Tonello, Simone; Tollot, Saverio; DęBiec, Aleksander; Staszewski, Jacek; Stepien, Adam; Bernardo, Francisco; Ferrao, Jorge; Zedde, Marialuisa; Pascarella, Rosario; Sanna, Alessandra; Meloni, Rossella; Delibas, Sennur; Sacco, Simona; Vittorini, Maria Grazia; Ornello, Raffaele; Mannino, Marina; Terruso, Valeria; Filizzolo, Marco; Hall, Emily; Roffe, Christine; Dorobek, Malgorzata; Zielińska-Turek, Justyna; Scopelliti, Giuseppe; Pantoni, Leonardo; Pero, Guglielmo C; Macera, Antonio; Cervo, Amedeo; Bellavia, Simone; Sezgin, Mine; Dilmen, Yavuz; Ekizoglu, Esme; Tsivgoulis, Georgios; Theodorou, Aikaterini; Tiu, Vlad; Panea, Cristina Aura; Petrescu, Simona; Piano, Mariangela; Nguyen, Thanh N; Sessa, Maria |
| Contributors: |
CAN-REST Study Group |
| Publication Year: |
2026 |
| Collection: |
Université de Lausanne (UNIL): Serval - Serveur académique lausannois |
| Subject Terms: |
Humans; Male; Female; Aged; Ischemic Stroke; surgery; Thrombectomy; adverse effects; Acute Kidney Injury; chemically induced; epidemiology; diagnosis; Contrast Media; Retrospective Studies; Prognosis; Middle Aged; 80 and over; Hospital Mortality; Endovascular Procedures; Incidence |
| Description: |
Contrast-associated acute kidney injury (CA-AKI) is a potentially preventable complication after exposure to iodinated contrast media. In patients undergoing endovascular thrombectomy (EVT) for acute ischemic stroke (AIS), the incidence and clinical impact are poorly characterized, and no validated prediction tool is currently available. The aim of this study was to assess the incidence and prognostic significance of CA-AKI in EVT-treated patients with AIS and to develop and validate a predictive score. A retrospective, multicenter cohort study was conducted involving EVT-treated patients across 73 centers in 16 countries (January-December 2023). Inclusion criteria were age ≥18 years, absence of dialysis, availability of preprocedural and 48-hour postprocedural creatinine levels, and available 90-day follow-up (modified Rankin Scale [mRS] score). The primary outcome was CA-AKI, defined by KDIGO (Kidney Disease: Improving Global Outcomes criteria;creatinine increase ≥0.3 mg/dL or ≥1.5 times baseline, within 48 hours). Secondary outcomes were (1) in-hospital mortality, (2) 90-day mRS score, and (3) 90-day severe disability or death (mRS score >3). Logistic models assessing associations with outcomes accounted for within-center clustering by applying robust standard errors. CA-AKI prediction models were developed across imputed data sets using univariable selection (p < 0.20), backward elimination (p < 0.05), and coefficient-based scoring after categorization of continuous predictors, with internal validation by bootstrap to obtain optimism-adjusted estimates. Among 6,638 patients (median age 74 years; 48.7% male), CA-AKI occurred in 326 (4.9%) and was independently associated with in-hospital mortality (adjusted odds ratio [aOR] 2.269; 95% CI 1.615-3.190), higher 90-day mRS scores (adjusted common odds ratio 1.584; 95% CI 1.110-2.258), and 90-day severe disability or death (aOR 1.530; 95% CI 1.057-2.216). A preprocedural risk model including 12 routine clinical variables-sex, ethnicity, arterial ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| ISSN: |
0028-3878 |
| Relation: |
Neurology; https://iris.unil.ch/handle/iris/279822 |
| DOI: |
10.1212/WNL.0000000000214655 |
| Availability: |
https://iris.unil.ch/handle/iris/279822; https://doi.org/10.1212/WNL.0000000000214655 |
| Accession Number: |
edsbas.98B15572 |
| Database: |
BASE |