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Incidence and Risk Factors for Acute Transient Contrast-Induced Neurologic Deficit: A Systematic Review With

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Summary
This summary is machine-generated.

Acute transient contrast-induced neurological deficit (ATCIND) occurs rarely after angiography, with an incidence of 0.51%. Higher contrast doses and prior stroke are identified risk factors, but most patients fully recover.

Keywords:
acute transient contrast‐induced neurologic dysfunctioncontrast associatedcontrast‐induced encephalopathycontrast‐induced neurotoxicitycortical blindnessincidenceneurologic dysfunction

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Area of Science:

  • Neurology
  • Radiology
  • Clinical Trials

Background:

  • The rise in endovascular procedures following MR CLEAN has increased focus on potential complications.
  • Acute transient contrast-induced neurological deficit (ATCIND) is a neurological syndrome linked to arterial contrast administration during angiography.
  • Understanding ATCIND's incidence, risk factors, and outcomes is crucial.

Purpose of the Study:

  • To determine the incidence of ATCIND following coronary or cerebral angiography.
  • To identify risk factors, demographics, treatment modalities, and recovery patterns associated with ATCIND.

Main Methods:

  • A systematic review and meta-analysis of studies published between 1974 and 2021.
  • Searched databases including MEDLINE, Embase, Web of Science, and Cochrane Library.
  • Included studies reporting incidence of contrast-induced encephalopathy, neurotoxicity, or cortical blindness, with ≥3 cases and follow-up to exclude other causes.

Main Results:

  • The pooled incidence of ATCIND was 0.51% (95% CI, 0.3%-1.0%).
  • Significant risk factors included higher contrast dose (OR, 1.072) and prior stroke (OR, 5.153).
  • Contrast dose >150 mL predicted visual disturbance (OR, 7.083); 89.5% of patients achieved full recovery.

Conclusions:

  • ATCIND is a rare complication of angiography, with an incidence of 0.51%.
  • Increased contrast volume and history of stroke are key risk factors.
  • Most patients experience full recovery, but ATCIND should be considered in differential diagnoses for at-risk patients.