introduction: iatrogenic aortocoronary dissection (acd) is a nightmare in interventional cardiology. although acd is rarely reported, the real-world prevalence is suspected of being higher due to unreported cases. the right coronary artery (rca) ostium is involved in the majority of cases, and dissections are usually limited to the aortic sinus in half of the clinical presentations. there are d...

BACKGROUND N-acetylcysteine (NAC) has been proposed to prevent radiocontrast nephropathy in high-risk patients. METHODS The effect of single-dose and prolonged administration of NAC before application of either the ionic, high-osmolar radiocontrast agent diatrizoate sodium (DTZ) or the nonionic, low-osmolar radiocontrast agent iohexol (IOH) in a rat model combining uninephrectomy, salt deplet...

Dr. P. Cacoub, Department of Nephrology, Hôpital Pitié-Salpêtrière, 47-83, boulevard de l’Hôpital, F-75651 Paris Cédex 13 (France) Dear Sir, Acute renal failure has long been recognized as a potential hazard of radiocontrast administration, especially in patients with preexisting renal failure [1]. Recently developed low osmolar agents have been considered less nephrotoxic, but some studies ind...

Dr. P. Cacoub, Department of Nephrology, Hôpital Pitié-Salpêtrière, 47-83, boulevard de l’Hôpital, F-75651 Paris Cédex 13 (France) Dear Sir, Acute renal failure has long been recognized as a potential hazard of radiocontrast administration, especially in patients with preexisting renal failure [1]. Recently developed low osmolar agents have been considered less nephrotoxic, but some studies ind...

Dose and route of administration of N-acetylcysteine are key factors to consider when evaluating whether this agent is effective in preventing radiocontrast induced nephropathy.

BACKGROUND Radiocontrast-induced nephropathy is a clinically important complication of invasive cardiological procedures. It has been associated with DNA fragmentation of renal tubular cells, which is a hallmark feature of programmed cell death (apoptosis). We investigated the mechanism of this DNA fragmentation in an in vitro model of radiocontrast cytotoxicity on renal epithelial cells. MET...

The pathogenesis of radiocontrast nephropathy is poorly understood. In an animal model, inhibition of the synthesis of nitric oxide and prostaglandins appears to predispose rats to severe renal injury following the administration of radiocontrast. Here we have investigated whether administration of radiocontrast, as well as changes in renal medullary oxygenation following pharmacologic inhibiti...

Prevention of contrast agent-induced nephropathy is of crucial importance for a number of diagnostic studies. N-Acetylcysteine (NAC) was recently reported to decrease serum creatinine levels in this setting, and its administration before radiocontrast medium administration has been widely recommended. The objective of this prospective study was to investigate whether there are effects of NAC on...

Acute renal failure still occurs as a complication after radiographic examination using iodinated radiocontrast medium. The incidence rate of radiocontrast medium-induced nephropathy (radiocontrast nephropathy) is low (2 - 3%) in general. However, the rate is remarkably elevated in patients with pre-existing renal insufficiency. Radiocontrast nephropathy is associated with increased morbidity a...

Prevention of radiographic-contrast-agent-induced reductions in renal function by acetyl-cysteine. N-acetylcysteine and contrast-induced nephropathy: a metaana-lysis of 13 randomized trials. A et al. Standard vs double dose of N-acetylcysteine to prevent contrast agent associated nephrotoxicity. Ascorbic acid prevents contrast-mediated nephropathy in patient with renal dysfunction undergoing co...