The preventive effects of different doses of atorvastatin on contrast-induced acute kidney injury after CT perfusion.

BACKGROUND: Contrast-induced acute kidney injury (CI-AKI) is a severe complication among patients receiving intravascular contrast media. The purpose of this study was to investigate the preventive effects of pretreatment of atorvastatin at intensive doses on CI-AKI after computed tomography (CT) perfusion. METHODS: The levels of serum creatinine (SCR), blood urea nitrogen (BUN), Cystatin C (CysC), estimated glomerular filtration rate (eGFR), high-sensitivity C-reactive protein (hs-CRP), and interleukin-6 (IL-6) in patients were compared between the observation group receiving 40 mg/kg atorvastatin and the control group receiving 20 mg/kg atorvastatin before and 72 h after CT examination. In addition, the incidence of CI-AKI was recorded. RESULTS: Compared with the control group, the incidence of renal injury in the observation group was significantly reduced, from 8% to 2% (χ2  = 6.62, p = 0.010). In addition, there was no notable difference in the levels of Scr, BUN, CysC, hs-CRP, and IL-6 before CT examination between two groups (p > 0.05). The levels of SCR, BUN, CysC, hs-CRP, and IL-6 were increased, while the levels of eGFR were decreased in the control group at 72 h after CT examination (p < 0.05). At 72 h after CT enhancement, the levels of BUN, CysC, and hs-CRP were prominently increased in the observation group (p < 0.05), while SCR, eGFR, and IL-6 did not change (p > 0.05). Compared with the control group, the levels of SCR, BUN, CysC, eGFR, hs-CRP, and IL-6 in the observation group were significantly decreased at 72 h after CT examination (p < 0.05). CONCLUSION: Intensive dose of atorvastatin pretreatment can prevent CI-AKI undergoing CT perfusion through lowering inflammation as well as renal function indexes SCR, CysC, BUN, and eGFR.

[Treatment of wide-necked cerebral aneurysms using stent and balloon-assisted technique].

OBJECTIVE: To discuss the avail of balloon and stent-assisted Guglielmi detachable coil (GDC) placement in treatment of wide-necked cerebral aneurysm. METHODS: Eighty-seven patients with 92 wide-necked aneurysms undergone endovascular procedures using the balloon and stent-assisted remodeling technique. Respectively, appropriate Neuroform stents delivered with a 5 mm landing zone on either side of the aneurysm neck, the microcatheter entered through the interstice, aneurysms were embolized at one or several times. Two catheters were used in balloon-remodeling technique, balloon were inflated across the neck of the aneurysms after the microcatheter entering the aneurysms, then the GDC were used to embolize the aneurysms. RESULTS: Thirty-one aneurysms were completely occluded, 3 subtotally (> 90%) and 1 incompletely (70% - 90%) occluded using stent-assisted technique, all carry arteries were unblocked, 3 patients with mild neurological dysfunction and no mortality. Fifty aneurysms were completely occluded and 4 incompletely occluded using balloon-assisted technique, 1 patients with mild neurological dysfunction and no mortality. Two aneurysms were completely occluded and 1 incompletely occluded using stent-assisted and balloon-assisted technique. The mean period of follow-up was 5.8 months. Rates of recanalization were 16.7% for stent-remodeling group and 12.5% for balloon-remodeling group. CONCLUSIONS: The stent and balloon-assisted remodeling technique are safe and effective in treating wide-necked aneurysms. Balloon-remodeling technique has more security comparing with stents.

[3-dimension computed tomography angiography and digital subtraction angiography in diagnosis of intracranial aneurysm: a comparative study].

OBJECTIVE: To compare the appliance values off 3-dimension computed tomography (CTA) and digital subtraction angiography (DSA) in diagnosis of intracranial aneurysm (ICA). METHODS: Eighty-six with subarachnoid hemorrhage underwent 2-D DSA, and 3-DCTA and 3-D DSA, both including maximum intensity projection (MIP) and multiple planner reconstruction (MPR), volume rending (VR). The accuracy, misdiagnosis rate, and missed diagnosis rate of these 3 techniques were compared. No significant complication was found. RESULTS: Ninety-four aneurysms were found in 74 patients. CTA examination obtained satisfactory MPR, MIP, and VR images in all patients. There was no significant difference in accuracy between 3D-DSA and 3D-CTA. In display of the aneurysm 3D-CTA was not significantly different from 2D-DSA in most cases. In display of the neck of aneurysm 3D-CTA was not significantly different from 3D-DSA, and these 3 techniques were both superior to 2D-DSA. CONCLUSION: 3D-CTA is the first choice examination technique for patients with subarachnoid hemorrhage. The information obtained by 2D-DSA, 3D-DSA, and 3D-CTA should be considered comprehensively.