Renal Insufficiency and Contrast Nephropathy
Intra Vascular Ultrasound Guided Zero-contrast Percutaneous Coronary Intervention in Chronic Kidney Disease Patients: Feasibility and Short-term Outcome
Prathapkumar Natarajapillai1, Blessvin Jino1
Meditrina Hospital, India1
Contrast-induced acute kidney injury (CI-AKI) is a serious complication after percutaneous coronary intervention (PCI) and it is associated with poor short-term and long-term outcomes. With the advent of intravascular ultrasound (IVUS) imaging, zero-contrast PCI is feasible and it helps in preventing CI-AKI. Our study aims to assess the safety and short- term outcome of IVUS guided zero-contrast PCI in chronic kidney disease (CKD) patients with complex demographics or lesion morphology.
Patients underwent “Zero- contrast PCI” if they had indication for revascularization and they had met any of the following criteria: (1) eGFR<30 mL/min/m2
; (2) eGFR<45 mL/min/m2
with age >75 years and/or left ventricular ejection fraction (LVEF) <35%. Technical success was defined as minimal stent area (MSA) > 80% of average reference lumen with no significant edge dissections and plaque burden of<50% at landing zones. Procedural success was defined as technical success without in-hospital mortality.
Zero-contrast PCI guided by IVUS is safe in coronary artery disease (CAD) patients with moderate-to-severe CKD. High procedural success can be achieved even in cases with complex clinical characteristics and lesion morphology.