الفهرس 
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Abstract
C
ontrast induced nephropathy (CIN) is one of the agreed upon complications of procedures that foresee the use of contrast media, recognized as a leading cause of morbidity and mortality in patients undergoing percutaneous coronary intervention (PCI) and is commonly defined as an increase in serum creatinine levels; usually 0.5 mg/dl or 25% of baseline levels, within 24–48h after contrast exposure.
The aim of the work is to predict the development of contrast induced nephropathy in patients undergoing chronic total occlusion after per-cutaneous coronary intervention.
This study is a prospective observational study, the sample was taken consecutively. The study data was obtained from all subjects who were admitted to Ain Shams affiliated hospitals, Cairo, Egypt, conducted in a prospective consecutive manner in our hospital over period of 6 months commencing in June 2021. The study is approved through FMASU REC which is organized and operated to guidelines of the inter- national council on Harmonization(ICH) and the Islamic organization for medical sciences (IOMS), The united states office for human research protections and the united code of federal regulations and operates under federal wide assurance no. FWA 000017585.
We enrolled 75 patients with documented CTO lesions with planned revascularization during period of 6 months commencing in June 2021. Detailed information for clinical, angiographic, and baseline/follow-up creatinine level outcomes was evaluated using data from Ain Shams university hospitals.
Our results showed that the long procedure time for CTO-PCI requires a large contrast volume, which adds to the problem of CIN. Hence, it is of utmost clinical importance to identify high-risk patients for CIN before PCI and prepare pre-procedural therapeutic intervention to minimize the risk of such complication. Hence, these factors should be taken into consideration for predicting the incidence of CIN before PCI. Contrast volume and procedure time are important predictors of CIN; therefore, decreasing the contrast dose and minimizing the procedure time are important factors to reduce the incidence of CIN. Further investigations are needed to confirm the results of our-study.
We concluded that contrast volume more than 240 ml, procedure time longer than 110 min are associated with higher risk of CIN. In addition, rise of serum creatinine more than >0.1 mg/dl or 21.4% in 24 hrs can be used as predictor for development of CIN at 48hrs, requiring prolong hospital stay. Therefore, Contrast volume, absolute rise or percentage rise of serum creatinine in 24 hrs, procedure time Can be used as a simple pre-procedural predictor of CIN among patients with CTO who undergoing interventional therapy PCI.