Delayed Contrast Medium Excretion Due to Renal Failure After an Emergency Mechanical Thrombectomy for Acute Cerebral...

We report a case in which mechanical thrombectomy (MT) was performed on a patient with cerebral infarction and renal failure, and contrast leakage remained on postoperative head computed tomography (CT) scans for more than 24 hours. A 75-year-old woman with a medical history of chronic renal failure due to diabetic nephropathy was admitted to the cardiology department of our hospital with chronic heart failure. During hospitalization, her diabetic nephropathy worsened. Therefore, dialysis was scheduled for introduction, but two days before the scheduled start of dialysis, she suffered a cerebral infarction due to right middle cerebral artery occlusion. Emergency MT was performed, and successful recanalization was achieved. A postoperative head CT scan revealed high-density areas along the cortex in the right frontal and temporal lobes, and this finding persisted for more than three days after the operation. Based on the neurological findings, head magnetic resonance imaging (MRI), and dual-energy CT (DECT) results, this high-density area was diagnosed as contrast agent leakage. The purpose of the current case report is to present a rare case of delayed contrast medium excretion after thrombectomy, management of such cases, and a review of existing literature.