Incidence and risk factors of contrast-induced sialadenitis after therapeutic neuroendovascular procedures

BACKGROUND AND PURPOSE: Swelling of the salivary glands, known as contrast-induced sialadenitis (CIS), is an adverse reaction to iodide contrast agents. However, the incidence and risk factors of CIS after therapeutic neuroendovascular procedures have not yet been established.

MATERIALS AND METHODS: Demographic and procedural factors that may influence the development of CIS were retrospectively analyzed to identify the incidence and risk factors of this condition. A total of 780 patients who underwent therapeutic neuroendovascular procedures between January 1, 2022 and December 31, 2022 were investigated. The risk factors affecting CIS were analyzed using multivariate logistic regression, and the quantitative degree of association between the volume of contrast administered and occurrence of CIS was determined using the receiver operating characteristic (ROC) curve.

RESULTS: The incidence of CIS after therapeutic neuroendovascular procedures was 4.2%. Multivariate logistic regression analysis showed that female sex (odds ratio [OR] = 4.420, 95% confidence interval [CI]: 1.377-14.190, p = 0.013), volume of contrast administered (OR = 1.007, 95% CI: 1.003-1.101, p < 0.001), and guiding catheter tip located within the external carotid artery (ECA) (OR = 8.701, 95% CI: 3.459-21.885, p < 0.001) were independently associated with CIS occurrence after therapeutic neuroendovascular procedures. The volume of contrast administered had an area under the ROC curve of 0.723 (95% CI:0.635-0.810; p < 0.001), and the optimal cut-off value of the volume of contrast administered was 205 cc (sensitivity: 0.49, specificity: 0.87).

CONCLUSIONS: We observed CIS in 4.2% of our patients undergoing therapeutic neuroendovascular procedures. This represents a higher incidence than previously reported. Female sex, volume of contrast administered, and guiding catheter tip located within the ECA are associated with CIS incidence.

ABBREVIATIONS: AUC = area under the ROC curve; BMI = body mass index; CIS = contrast-induced sialadenitis; ECA = external cerebral artery; GFR = glomerular filtration rate; ROC = receiver operating characteristic.