Abstract Details

Title Computed Tomography Perfusion Imaging in Evaluation of Patients With Acute Stroke is Not Associated With Increased Risk of Acute Kidney Injury

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P5 - Poster Session 5 (5:30 PM-6:30 PM)

Poster/Presentation
Number 3-051

Objective

In patients undergoing assessment for EVT eligibility, is CTA/CTP associated with higher incidence of acute kidney injury (AKI) compared to CTA alone?

Background Mechanical thrombectomy is standard of care in acute ischemic stroke with proximal arterial occlusion. For patients 6-24 hours from last known well, computed tomography perfusion (CTP) is frequently used for assessment of endovascular therapy (EVT) eligibility. CTP requires an increased contrast load compared to computed tomographic angiography (CTA).

Design/Methods We reviewed data from acute stroke alerts over 9 months at our institution, and recorded baseline serum creatinine and creatinine at 24, 48, and 72 hours post-alert. AKI was defined by an increase in serum creatinine of 0.3, or more than a 1.5 fold increase in creatinine, according to the Acute Kidney Injury Network. We compared patients receiving CTA/CTP versus CTA alone using independent samples t-test, including variables of age, NIHSS, baseline creatinine, and creatinine at 24, 48, and 72 hours. Chi-square testing was performed to compare incidence of AKI between groups. A binary logistic regression model was performed including covariates of age, sex, location (emergency room or inpatient), NIHSS, baseline creatinine and imaging group. Significance was defined as p < 0.05.

Results Analysis included 360 patients: 253 receiving CTA alone, and 107 receiving CTA/CTP. Incidence of AKI was 4.3% in the CTA group versus 4.7% in the CTA/CTP group ( χ²=0.19, p=0.891). The groups did not differ with regard to age, NIHSS, or serum creatinine. In the binary logistic regression model, addition of CTP to CTA did not increase the odds ratio of developing AKI (OR 0.962 [95% CI 0.305-3.03]; p=0.947).

Conclusions In acute stroke assessment for EVT eligibility, the addition of CTP to CTA did not increase rates of AKI. While this retrospective analysis includes the possibility of selection bias, the two groups were similar in baseline characteristics including kidney function.

Authors/Disclosures
Kelsey Satkowiak, MD PRESENTER	No disclosure on file
Joseph F. Carrera, MD	Dr. Carrera has nothing to disclose.
Andrew M. Southerland, MD, FAAN (University of Virginia, Dept of Neurology)	Dr. Southerland has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Plaintiffs and Defense Cases related to Stroke and Vascular Neurology.. The institution of Dr. Southerland has received research support from American Heart Association. The institution of Dr. Southerland has received research support from NIH. The institution of Dr. Southerland has received research support from Abbvie Pharmaceuticals, Inc.. Dr. Southerland has received intellectual property interests from a discovery or technology relating to health care. Dr. Southerland has received intellectual property interests from a discovery or technology relating to health care.

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