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CompletedNCT06596603CAN-RESTUpdated Jul 30, 2025

Contrast-Associated Nephropathy Risk Evaluation in Acute Ischemic Stroke After Endovascular Thrombectomy

An observational study in Contrast-Associated Acute Kidney Injury, sponsored by Niguarda Hospital. Completed at 1 site in Italy. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-07-30.

Sponsored by Niguarda Hospital · Observational

Study type
Observational
Model
Cohort
Time perspective
Retrospective
Enrollment
8,000
Ages
18 Years and older
Sex
All
01

Study summary

The CAN-REST study is a multicenter, observational, and retrospective study aimed at evaluating the incidence and risk factors of contrast-associated acute kidney injury (CA-AKI) in patients with acute ischemic stroke (AIS) who undergo endovascular thrombectomy (EVT). This study is conducted across multiple centers in Italy, Europe, the USA, and Canada, and includes data from AIS patients treated with EVT in 2023. The primary objectives are to assess the incidence of CA-AKI in this population and identify associated risk factors. Secondary objectives include evaluating the impact of CA-AKI on clinical outcomes, such as the length of hospital stay, functional recovery, and 90-day mortality, as well as developing risk stratification tools to predict CA-AKI. By analyzing a large cohort of patients, CAN-REST aims to provide critical insights into the renal complications associated with EVT and establish predictive models that can guide clinical decision-making and improve patient outcomes.

Read the detailed description

The CAN-REST study is a multicenter, observational, and retrospective study designed to evaluate the incidence and risk factors of contrast-associated acute kidney injury (CA-AKI) in patients who have suffered an acute ischemic stroke (AIS) and subsequently underwent endovascular thrombectomy (EVT). The use of contrast agents during EVT, essential for visualizing blood vessels and guiding the procedure, poses a risk for CA-AKI, particularly in patients who are already in a vulnerable state due to stroke-related comorbidities and the acute nature of their condition.

The primary objective of the study is to assess the incidence of CA-AKI in AIS patients following EVT and to identify specific risk factors that contribute to the development of CA-AKI. Secondary objectives include evaluating the impact of CA-AKI on clinical outcomes, such as the length of hospital stay, functional recovery as measured by the modified Rankin Scale (mRS) at discharge and 90 days post-procedure, and all-cause mortality at 90 days. Additionally, the study aims to develop and validate risk stratification tools that can predict the likelihood of CA-AKI based on both baseline patient characteristics and procedural variables related to EVT.

The study population consists of all consecutive AIS patients treated with EVT in participating centers from January 1, 2023, to December 31, 2023. Data collection will include detailed information on patient demographics, clinical history, stroke severity, procedural details of EVT, and subsequent renal function assessments to determine the development of CA-AKI. Two predictive models will be developed: one using only pre-EVT variables and another incorporating EVT-related variables to better stratify patients according to their risk for developing CA-AKI.

By analyzing a large cohort of patients from multiple centers worldwide, CAN-REST aims to provide valuable insights into the renal complications associated with the use of contrast media in EVT for AIS patients. The study's findings are expected to guide clinical practice by identifying high-risk patients and enabling the development of preventative strategies, ultimately improving patient outcomes and care standards in stroke treatment.

02

Conditions studied

  • Contrast-Associated Acute Kidney Injury
03

In context

Lead sponsor

Niguarda Hospital is the lead sponsor of 66 studies on the registry; 28 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

All consecutive EVT-treated acute ischemic stroke patients discharged at the participating centers from 1 January 2023 to 31 December 2023.

Eligibility criteria

To be eligible to participate in this study, subjects must meet all of the following criteria:

  • Age >18 years at the time of AIS
  • Documented serum creatinine:

    • pre-EVT and
    • within 48h and/or within 7 days after EVT. Patients on chronic dialysis will be collected but excluded from the analyses
05

Study design

Observational model
Cohort
Time perspective
Retrospective
Enrollment
8,000 participants (actual)
Patient registry
No
06

What researchers measure

Primary outcomes

  1. Incidence of Contrast-Associated Acute Kidney Injury (CA-AKI)

    Measure the occurrence of acute kidney injury characterized by an increase in serum creatinine ≥0.3 mg/dL or ≥50% within 48 hours, or an increase of ≥0.3 mg/dL within 7 days post-endovascular thrombectomy in acute ischemic stroke patients.

    Time frame: Within 48 hours and up to 7 days post-endovascular thrombectomy.

Secondary outcomes

  1. Days of In-Hospital Stay

    Measure the total number of days patients remain hospitalized following endovascular thrombectomy

    Time frame: Measured daily from hospital admission until the day of discharge post-endovascular thrombectomy, assessed up to 30 days

  2. Functional Recovery (modified Rankin Scale, mRS; ranging from 0 [full recovery] to 6[death])

    Assess the level of disability or dependence in daily activities of patients post-stroke, measured at discharge and at 90 days post-procedure

    Time frame: 90 days post-procedure

  3. All-Cause Mortality at 90 Days (modified Rankin Scale, mRS = 6)

    Measure the number of deaths from any cause within 90 days following endovascular thrombectomy Time Frame: 90 days post-procedure.

    Time frame: 90 days post-procedure

  4. Development of Risk Stratification Tools

    Create and validate predictive models for CA-AKI using baseline and EVT-related variables to categorize patients into risk groups (low, medium, high)

    Time frame: 24 hours, 48 hours, at 3 months, and at 12 months post-endovascular thrombectomy

07

Study locations

1 site
  • ASST Grande Ospedale Metropolitano Niguarda
    Milan, Lombardy 20162, Italy
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jul 30, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT06596603
Lead sponsor
Niguarda Hospital
Responsible party
Sponsor
First posted
Sep 19, 2024
Start date
Mar 1, 2023
Primary completion
Dec 31, 2024
Completion
Jul 1, 2025
Last update
Jul 30, 2025

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Jul 2025. You cannot join it, but the record below documents what was studied.

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