Multivessel percutaneous coronary intervention without contrast agents

Contrast-induced nephropathy (CIN) following coronary angiography is associated with significant morbidity and mortality. Contrast media volume is the key risk factor for CIN in patients with chronic kidney disease undergoing coronary angiography and interventions. Very often, coronary interventions...

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Bibliographic Details
Published in:Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions 2016, Vol.88 (7), p.E222-E226
Main Authors: Vidi, Venkatesan D, Barseghian, Ailin, Garratt, Kirk N
Format: Report
Language:English
Online Access:Get full text
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Summary:Contrast-induced nephropathy (CIN) following coronary angiography is associated with significant morbidity and mortality. Contrast media volume is the key risk factor for CIN in patients with chronic kidney disease undergoing coronary angiography and interventions. Very often, coronary interventions are avoided in such high-risk patients because of possible significant adverse clinical outcomes. We present a case demonstrating use of intravascular ultrasound (IVUS) to guide multivessel percutaneous coronary intervention (PCI) performed without any contrast administration in a patient with extreme risk for CIN. With the availability of advanced imaging of the coronary arteries such as high definition IVUS, contrast free PCI is a feasible approach and is associated with significant advantages of reducing or eliminating the development of CIN following PCI. This case report highlights the key practical aspects of performing contrast-free PCI and the challenges associated with such approach. © 2015 Wiley Periodicals, Inc.
ISSN:1522-726X
DOI:10.1002/ccd.26370